Today I want to talk a little bit about the abdominal binder. Some people have asked questions about this tool and how it can help after bariatric surgery.
I was about three hours out of surgery when I met my good friend, the abdominal binder. It looks similar to a back brace, but the support it provide is more spread through the wearer's core.
The nurse put the abdominal binder on me when I stood up for the first time post op (with the help of three people). I immediatley felt relief and the second time I stood up, I was able to walk around much longer than the first time.
By the end of the night, I was asking for a half dose of my heavy duty pain meds. I attribute all of this to the binder.
I wore the binder all day every day for two weeks. Luckily, my parents had one in the same size from a hospital stay of my dad's, so I was able to wash one while wearing the other.
After about two weeks, I started wearing the binder only if I left the house. This was because one day I went out without it and my energy levels were tanked. I think this only lasted about a week.
A lot of the questions I see about the binder start with "what is this thing and where can I buy one?" I recommend to people to wait until you're in the hospital and they will more than likely give you one. Then, you can look at the tag for the size, and buy a second one if you need it.
Some people respond that their doctor's don't want them wearing the binder, or not wearing it that much, as to not become dependent on it. My non-medical opinion of that is that thinking is not right. I'd rather be hooked on compression on my abs than hooked on oxy or other opioids.
I was lucky enough to have seven small incisions all held together with surgical glue, so putting the binder right on my skin felt fine. Some people have staples, and they suggest putting a t-shirt between your skin and the binder.
I will say this about the binder is that its hot. It's a thick fabric and it was unforgiving in the June heat right after my surgery.
Ask your doctor or nurses if the binder will be right for you!
Monday, July 31, 2017
Sunday, July 30, 2017
July 29, 2017: Eight weeks, three days
We are still in the process of getting back to normal after our vacation. We woke up early and each had different things to do, so we went our separate ways.
I ended up going to Wegmans with my parents just to get out for a few minutes. There, I found that they sold Quest Protein Chips in bulk (only 8 servings) for the same price as Amazon. I excitedly bought a box. We also found French Macaroons in the bakery, and they were surprisingly low carb, at 12 carbs a serving. A few months ago I would have eaten the three servings in the box, but my parents and I each had one serving of two.
After that I came home and continued to do housework and decided to go to the gym a little later. My goal was originally 45 minutes on the elliptical but then I decided to change my goal to 4 miles in 40 minutes.
I rocked it.
At night we had a baseball game to go to at our local minor league field. It was a good time to hang out with friends.
Food journal:
Breakfast:
1 egg scrambled
Lunch:
2 macaroons
Think Thin Protein Bar (not a fan)
Dinner:
Canned tuna
1 TBSP of mayo
Quesadilla cheese
Snack:
Quest Protein chips
After the game:
GF Matzo
Workout journal:
40 minutes on elliptical keeping to under 10:00 miles
Added cool down
Arm workout
1-2-3-4-5-6-7-8-9-10-10-9-8-7-6-5-4-3-2-1 curls with 20 lb barbell
Single arm extensions 3x15 @15lbs
Saturday, July 29, 2017
July 28, 2017: Eight weeks and two days
Our first full day back from vacation and I was ready to get back to normal. Normal eating, normal drinking, and normal working out.
I woke up and did a fasted workout (if I eat before a workout, my colon won't let me finish). It was a PF 30 minute class and a PF 360 class kinda morning. I got home, had some protein and some coffee and planned on doing some laundry and housework and then going back to the gym at about 2:30.
Well...life had other plans.
I got my running shoes on and had my headphones in my pocket (and two bags of clothes that are too big for me now ready for a donation) and I was ready to go! But the landscapers were blocking our driveway. I could have asked them to move but there was a lot of drama yesterday with them, and our condo needed the landscaping. So I went back upstairs. An hour later I looked outside and this time they were blocking the driveway AND blocking my car with their heavy equipment. Also this whole time it was pouring and I'm not that hardcore about my run yet.
Finally it was 4:30 and my husband was due home any minute so I didn't want to look like I was avoiding him ("Oh, so glad you're home from your long day at work, I'm going to the gym byeeee"). I ran out to get rid of those too-big clothes and came back home.
We went out for dinner to Panera so I can finally try that salad and it went down great! I'm so happy to have lettuce back in my life.
Another great thing that happened today was that I crowdsourced some topic ideas for this blog from my friend list and the response I got was amazing. There are so many things that non-bariatric patients are interested in and I'm so glad I can try to help them out.
Food journal:
Breakfast:
Protein Shake
Morning snack:
Banana
Lunch:
Corn Quesadilla
Afternoon snack:
Applesauce
Dinner:
Half a Greek Salad from Panera (no added meat)
Evening snack:
Protein shake (was less than 50g of protein by this point so I needed it more than I wanted it)
Workout journal:
PF 30 minute circuit (one day I'll take good notes on each exercise to help loyal readers)
PF360
I woke up and did a fasted workout (if I eat before a workout, my colon won't let me finish). It was a PF 30 minute class and a PF 360 class kinda morning. I got home, had some protein and some coffee and planned on doing some laundry and housework and then going back to the gym at about 2:30.
Well...life had other plans.
I got my running shoes on and had my headphones in my pocket (and two bags of clothes that are too big for me now ready for a donation) and I was ready to go! But the landscapers were blocking our driveway. I could have asked them to move but there was a lot of drama yesterday with them, and our condo needed the landscaping. So I went back upstairs. An hour later I looked outside and this time they were blocking the driveway AND blocking my car with their heavy equipment. Also this whole time it was pouring and I'm not that hardcore about my run yet.
Finally it was 4:30 and my husband was due home any minute so I didn't want to look like I was avoiding him ("Oh, so glad you're home from your long day at work, I'm going to the gym byeeee"). I ran out to get rid of those too-big clothes and came back home.
We went out for dinner to Panera so I can finally try that salad and it went down great! I'm so happy to have lettuce back in my life.
Another great thing that happened today was that I crowdsourced some topic ideas for this blog from my friend list and the response I got was amazing. There are so many things that non-bariatric patients are interested in and I'm so glad I can try to help them out.
Food journal:
Breakfast:
Protein Shake
Morning snack:
Banana
Lunch:
Corn Quesadilla
Afternoon snack:
Applesauce
Dinner:
Half a Greek Salad from Panera (no added meat)
Evening snack:
Protein shake (was less than 50g of protein by this point so I needed it more than I wanted it)
Workout journal:
PF 30 minute circuit (one day I'll take good notes on each exercise to help loyal readers)
PF360
- Ropes-10 seconds arms together, 10 seconds arms alternating
- TRX suspension: Lunges
- Upright rows (17.5 lbs)
- Wall squat with a chest pass (6 lbs ball) against the trampoline
- Kettle bell side touches (15 lbs first round, 20 lbs second round)
- Hip bridges with elevated legs and 10 lbs on stomach
The first three were done three times and the second three two times.
Friday, July 28, 2017
Lady Concerns (Consider yourselves warned)
Frequently, online I see people asking questions about how this surgery affects a woman's unique health issues. I would like to take more time and words than a comment on a post about this and what my experiences have been.
From the start, the surgeon told me to get off of my estrogen-based birth control method of choice. The estrogen puts individuals at a higher risk for blood clots (as does obesity) so it had to go, and I completely understood.
Also, I was told to not get pregnant for eighteen months. This was actually a deciding factor in getting the surgery since 16 months from now (that I'm two months out) our personal finances will have recovered from a step back for better job security.
The need for non-estrogen based birth control and the year and a half wait made an implant make more sense.
About six weeks after the initial surgeon appointment I finally got in to see my gyno. We discussed the implant options and decided the Nexplanon implant would be best. Nexplanon goes into the upper arm and I can check to make sure it hasn't moved whenever I want.
On May 1 (T-30 days before surgery) I got the implant. It was a five minute process once the doctor came into the room. They did a pregnancy test to make sure I wasn't pregnant, numbed my arm, and in the Nexplanon went. I barely experienced any bruising, the pain was nothing an Advil wouldn't help, and I couldn't lift weights with my arms for a week. But, I was good for birth control until May 1, 2020. Overall, a very positive experience.
About two weeks later, I experienced a normal period on my regular schedule.
On May 31, I had my surgery and the next day, June 1, I started to experience some discharge that could almost be described as a period. This discharge did not stop.
Two weeks later, I experienced a real period, again right about on schedule. Once that stopped, I again went back to the stranger discharge. At that point I had another gyno visit scheduled and I went for it. I go to a practice and am not picky about who I see. So I was seeing this nurse practitioner for the first time. I explained my history and she said what I was experiencing was nothing to be concerned about. After all, I changed my hormones AND underwent a major surgery, so I should cut my body some slack.
I again had a normal cycle about on schedule, and now, eight weeks later, the discharge is finally ending.
Now that's my story. From this point on are my theories.
I admit that part of the reason I had this surgery was for fertility. My husband and I had about two months of actively trying to get pregnant before our situation changed. We weren't discouraged by two months of no luck at all, but increased fertility certainly made the surgery that much more attractive. Also, its not just the getting pregnant and having a healthy pregnancy, but also chasing a baby around, then doing the whole thing again with a second pregnancy and a second baby. I couldn't imagine being able to do that over 300 pounds.
The whole having my period for basically two months was really annoying. But I didn't really cramp. I did however bloat and weighing myself every day would get discouraging at times. That was when I decided to not weigh myself every day. From things I read online, I knew not to be concerned, but getting in with my provider made me feel a lot better.
From the start, the surgeon told me to get off of my estrogen-based birth control method of choice. The estrogen puts individuals at a higher risk for blood clots (as does obesity) so it had to go, and I completely understood.
Also, I was told to not get pregnant for eighteen months. This was actually a deciding factor in getting the surgery since 16 months from now (that I'm two months out) our personal finances will have recovered from a step back for better job security.
The need for non-estrogen based birth control and the year and a half wait made an implant make more sense.
About six weeks after the initial surgeon appointment I finally got in to see my gyno. We discussed the implant options and decided the Nexplanon implant would be best. Nexplanon goes into the upper arm and I can check to make sure it hasn't moved whenever I want.
On May 1 (T-30 days before surgery) I got the implant. It was a five minute process once the doctor came into the room. They did a pregnancy test to make sure I wasn't pregnant, numbed my arm, and in the Nexplanon went. I barely experienced any bruising, the pain was nothing an Advil wouldn't help, and I couldn't lift weights with my arms for a week. But, I was good for birth control until May 1, 2020. Overall, a very positive experience.
About two weeks later, I experienced a normal period on my regular schedule.
On May 31, I had my surgery and the next day, June 1, I started to experience some discharge that could almost be described as a period. This discharge did not stop.
Two weeks later, I experienced a real period, again right about on schedule. Once that stopped, I again went back to the stranger discharge. At that point I had another gyno visit scheduled and I went for it. I go to a practice and am not picky about who I see. So I was seeing this nurse practitioner for the first time. I explained my history and she said what I was experiencing was nothing to be concerned about. After all, I changed my hormones AND underwent a major surgery, so I should cut my body some slack.
I again had a normal cycle about on schedule, and now, eight weeks later, the discharge is finally ending.
Now that's my story. From this point on are my theories.
I admit that part of the reason I had this surgery was for fertility. My husband and I had about two months of actively trying to get pregnant before our situation changed. We weren't discouraged by two months of no luck at all, but increased fertility certainly made the surgery that much more attractive. Also, its not just the getting pregnant and having a healthy pregnancy, but also chasing a baby around, then doing the whole thing again with a second pregnancy and a second baby. I couldn't imagine being able to do that over 300 pounds.
The whole having my period for basically two months was really annoying. But I didn't really cramp. I did however bloat and weighing myself every day would get discouraging at times. That was when I decided to not weigh myself every day. From things I read online, I knew not to be concerned, but getting in with my provider made me feel a lot better.
July 27, 2017: Eight weeks, one day
Today, my husband and I traversed through two countries and three states to get back home to Maryland. We started the drive early and did the entire drive in daylight.
I tried (gluten free) bread for the first time post-op today and it went well. But I have realized how important it is to start the day with a protein shake. I was super full for hours, even stopping for lunch four hours later I couldn't imagine putting anything in my mouth. I ordered a burger without a bun and took more that half of it to the car.
We finally got home at about 5pm, and we brought everything up, gave our kitties well deserved attention, and then I could have gone to the gym, but my entire body just hurt and ached from the ride, so I crocheted with some friends.
So, another not very exciting or detailed day to share, but tomorrow will be back to normal. It has to be.
I tried (gluten free) bread for the first time post-op today and it went well. But I have realized how important it is to start the day with a protein shake. I was super full for hours, even stopping for lunch four hours later I couldn't imagine putting anything in my mouth. I ordered a burger without a bun and took more that half of it to the car.
We finally got home at about 5pm, and we brought everything up, gave our kitties well deserved attention, and then I could have gone to the gym, but my entire body just hurt and ached from the ride, so I crocheted with some friends.
So, another not very exciting or detailed day to share, but tomorrow will be back to normal. It has to be.
Wednesday, July 26, 2017
Remembering Meds and Vitamins
The deeper I get into life as a bariatric patient, the more I truly believe the mantra of "failing to plan is planning to fail".
Someone, please buy me a bracelet.
Everything, from the gym, to food, to what the meat of this post is about, medication and vitamins, are carefully planned out. In just three months, this has become routine.
But lets turn our focus to strictly medication and vitamins. And lets start with storage. I use this pill holder. It's literally called "Lazy Me" and was the biggest one I could buy. Each day is broken up into four sections, which is exactly how my nutritionist said to pace things. I like it because I can pop one day out and take it with me all day. It's also just big enough for my biggest pills. I just have to worry about one little box all day.
Every Thursday night, I take my pill holder and all of my meds and put them into the proper days and times. In each section, I place the following:
I plan on updating my meds and vitamins very soon. (Updated: 8/11/2017) The change will be taking out protonix and splitting my multivitamin and my iron. The flavor of those tablets make me really nauseous and I want to try splitting them up. It will end up costing me about $30 more every three months if I decide to keep the change.
Someone, please buy me a bracelet.
Everything, from the gym, to food, to what the meat of this post is about, medication and vitamins, are carefully planned out. In just three months, this has become routine.
But lets turn our focus to strictly medication and vitamins. And lets start with storage. I use this pill holder. It's literally called "Lazy Me" and was the biggest one I could buy. Each day is broken up into four sections, which is exactly how my nutritionist said to pace things. I like it because I can pop one day out and take it with me all day. It's also just big enough for my biggest pills. I just have to worry about one little box all day.
Every Thursday night, I take my pill holder and all of my meds and put them into the proper days and times. In each section, I place the following:
- Morning
- Afternoon
- Celebrate Calcium Citrate
- Colace
Protonix(completed regimine)- Evening
- Celebrate Calcium Citrate
- Actigall
- Colace
- Bedtime
Two chewable Multivitamin plus 60 iron tablets(changed to splitting the MV from the Iron due to nausea issues)- Two chewable Mutltivitamins
- One Iron 60 chewable
I think one key to my success in remembering my meds and vitamins is to take everything in that section of pills at the appropriate time.
Speaking of appropriate times...this is a good time to share how I remember to take my pills.
My four times I get reminders are 5:45am, 11:30am, 2:30pm, and 6:00pm. I set these reminders through Baritastic but at three months I really don't need them. They've been great while I've been away though! The most important thing to remember is to space the calcium tablets out by at least two hours. So if I take my first section before leaving the house at 6:00am, and I look at the clock and it's 9:00am, I know I'm safe to go ahead and take it.
June 21-26: Seven weeks, two days to eight weeks
My husband and I are currently on a whirlwind road trip that took us from our Maryland home up to Toronto. On the way up, we stopped to see some of my family and some family friends before finally reaching Toronto.
The first day of the road trip went right according to plan. The one difference was going out to eat, but of course I had leftovers.
The second day of the road trip took us past some family, who put a lot of thought into what they served us for lunch (I had tuna salad). For dinner I had the leftovers from the night before.
The third day we went to the Baseball Hall of Fame which included a lunch out. Our gracious guests grilled up some burgers and hot dogs and I had half of each.
The fourth day was about 6 hours of driving. First we went to Niagara Falls, where I had a lunch that did not sit well with me. Upon arriving in Toronto, we went out to dinner and bought one meal to split between the two of us, and I think my stomach was already not doing too well since lunch so I spent about an hour vomiting during the first night we were finally at our destination.
The fifth day (and day one in Toronto) went great. My husband had a class all day so I spent the day wandering around the city myself. I made sure to pack a water bottle and a protein bar, and that sustained me through the day. For dinner, we went out with some of his classmates and I had some of the appetizers (oven baked nacho chips with vegan toppings), but by the time dinner came I had to put it all away to take home.
The sixth day was day two in Toronto. I spent time in the city again today and packed my protein bar and water again.
This was the first big trip we took since the bypass. I had spent a few days in Wildwood but the added complication of whole days in the car made this trip more difficult. This is what I've learned:
The first day of the road trip went right according to plan. The one difference was going out to eat, but of course I had leftovers.
The second day of the road trip took us past some family, who put a lot of thought into what they served us for lunch (I had tuna salad). For dinner I had the leftovers from the night before.
The third day we went to the Baseball Hall of Fame which included a lunch out. Our gracious guests grilled up some burgers and hot dogs and I had half of each.
The fourth day was about 6 hours of driving. First we went to Niagara Falls, where I had a lunch that did not sit well with me. Upon arriving in Toronto, we went out to dinner and bought one meal to split between the two of us, and I think my stomach was already not doing too well since lunch so I spent about an hour vomiting during the first night we were finally at our destination.
The fifth day (and day one in Toronto) went great. My husband had a class all day so I spent the day wandering around the city myself. I made sure to pack a water bottle and a protein bar, and that sustained me through the day. For dinner, we went out with some of his classmates and I had some of the appetizers (oven baked nacho chips with vegan toppings), but by the time dinner came I had to put it all away to take home.
The sixth day was day two in Toronto. I spent time in the city again today and packed my protein bar and water again.
This was the first big trip we took since the bypass. I had spent a few days in Wildwood but the added complication of whole days in the car made this trip more difficult. This is what I've learned:
- Don't test the waters with food while away. Have what you know works
- Make time to sit down and drink water
- Order one entree to feed two people. The leftovers we had floating around got tough to manage on the road
- Start the day with a protein shake even if there is a free breakfast at the hotel. On day five I had probably one egg and a single bite of sausage from the hotel breakfast and was stuffed (and unable to drink for 30 minutes). This was only 10g of protein at most. on day six I had a protein shake and things went better
- "Failing to prepare is preparing to fail" has basically become the mantra of how we travel.
As for workouts during this time, I got 15K and 10K steps in Toronto but besides that I was mentally and physically exhausted from driving. I can't wait to get back to the gym on Friday and get back into my routine.
Friday, July 21, 2017
July 20, 2017: Seven weeks, one day
Today was a day where a workout was just not going to happen. I'm still on the fence about workout out during lunch as this heat wave is upon us, but today was also a potluck for lunch (my first post-op) so that decision was made for me today.
For the potluck, I made a really simple deviled egg recipe. I've decided this will be my go to for potlucks and church events.
We're also going away tomorrow, and I had to buy stuff to make this road trip as successful as possible. I went to WalMart right after work hoping they sold a particular brand of protein powder and they did! And at the same price as Amazon!
Directly related to my needs for the trip, I bought the following (for the record I don't get any money/kickbacks from any company):
Chocolate and Vanilla Pure Protein
Quest bars
Applesauce packages
Think Thin bars
Beef Jerky
Already made Premier Protein Shakes
So...no lunch, not right after work, and I had support group. Prospects for working out were not good.
AND there was traffic galore. To the point where I nearly didn't go to support group, but as always I'm glad I did. The topic of discussion was hydration, which has been a struggle, and I was also the most recent post-op patient and plenty of pre-op patients had questions for me which I was glad to answer.
Food journal:
Breakfast:
Celebrate Protein (1.5 servings)
Lunch:
3 deviled eggs
Afternoon snack:
Oikos triple zero yogurt
Dinner:
1 serving of corn pasta with tomato sauce and quarter cup mozzarella cheese
For the potluck, I made a really simple deviled egg recipe. I've decided this will be my go to for potlucks and church events.
We're also going away tomorrow, and I had to buy stuff to make this road trip as successful as possible. I went to WalMart right after work hoping they sold a particular brand of protein powder and they did! And at the same price as Amazon!
Directly related to my needs for the trip, I bought the following (for the record I don't get any money/kickbacks from any company):
Chocolate and Vanilla Pure Protein
Quest bars
Applesauce packages
Think Thin bars
Beef Jerky
Already made Premier Protein Shakes
So...no lunch, not right after work, and I had support group. Prospects for working out were not good.
AND there was traffic galore. To the point where I nearly didn't go to support group, but as always I'm glad I did. The topic of discussion was hydration, which has been a struggle, and I was also the most recent post-op patient and plenty of pre-op patients had questions for me which I was glad to answer.
Food journal:
Breakfast:
Celebrate Protein (1.5 servings)
Lunch:
3 deviled eggs
Afternoon snack:
Oikos triple zero yogurt
Dinner:
1 serving of corn pasta with tomato sauce and quarter cup mozzarella cheese
May 31-June 1, 2017: Surgery and Hospital Stay
6:30am
The first thing I had to do this day was re-wipe myself using the instructions from my pre-op appointment. Since part of this involved my back, I woke up before my husband left for an appointment to help me out. I put on a new set of clothes, and went to bed.
8:15am
I woke up again and drank a bottle of Gatorade given to me from the pre-op appointment. I was told to have this done by 2 hours prior to my appointed arrival time of 10:30am. I got up, made sure everything I needed was in my bag, and my parents were due to arrive at about 9:30am to bring me.
In my bag, I packed:
2 pairs of underwear
2 pairs of comfy pajama or workout shorts
2 t-shirts
iPad
Charger (extra long)
Yarn and a crochet hook
Folder with all of my papers I got so far
Wallet
A hoodie in case I got cold
I wore comfortable clothes to the hospital. Something worth noting was that all of the clothes I brought were clothes I wouldn't mind losing. I kept the charger, my phone, iPad, and wallet in a place where someone would not easily be able to sneak in and grab them. Everything else stayed out of arms reach on a windowsill.
10:30am
We arrived at the hospital a few minutes early but soon enough they brought me into the back. First thing was first, they needed to make sure I wasn't pregnant. I remembered not to pee from the gatorade knowing this was coming, so I gave them my sample and came up negative. I changed into the hospital gown, and got my final pre-surgical weight.
Then, I got my first of 63 Lovenox shots that I would get or self-administer over the next 30 days. The nurse put a motion sickness patch behind my ear to help with nausea, and took a couple of tubes for testing. Then, they started the IV and hooked me up.
At that point my parents and husband were allowed to rejoin me. I was by far the least nervous person in the "room" if that's what you want to call it. It was probably about 11:30am by this time. I was due to go in at 12:30pm. Then the parade of medical professionals started. I don't remember the order, but that's probably not important. The surgeon stopped by to answer any questions my family had and I signed a consent for the surgery. The anesthesiologist stopped by to see how much I could open my mouth, and confirm what he already knew about me. Another anesthesiologist stopped by (there were two on the team) to introduce herself, and its a good thing she did because she was who I really talked to once they rolled me into the OR.
At around 1:00pm, the team came out to take me back. I gave my glasses and phone to my husband (taking off my glasses is my least favorite part of any procedure). I got rolled into the OR and shifted myself onto the table. The anesthesiologist got me positioned and explained that they have found that just a few minutes of CPAP therapy has proven to help patients going into surgery. The OR nurse strapped my legs into machines that pumped air into stockings to prevent blood clots. A few minutes passed by as they got me ready, and suddenly the time came where they instructed me that I would taste a metallic taste, smell something metallic, and possibly feel a burning sensation at the IV point.
5:35pm
The next thing I remember is waking up in the Post Anesthesia Care Unit (PACU) and the first feeling I felt was absolute nausea. A nurse was right by me and she was able to push Zofran to help with the nausea and was able to call out to my family that they could come back. In a few minutes I was reunited with my glasses (yay!) and they held me there for about 2 hours as I got more and more aware. The PACU is the only place I got inject-able pain management, but my pain was only at about a 5/10. My nausea on the other hand needed a second type of drug to finally get controlled.
7:45pm
Finally, a room became available and they rolled me up. For context of how well I was doing pain-wise, I was told immediately that I could have 10mg of oxy if I wanted. But I wanted to walk and use the rest room first. It took my husband and a nurse to get me out of bed, and I walked to the bathroom. I was able to do everything behind the privacy of a bathroom door, which was unexpected. My husband however had to help me put my underwear on. Once that was on, they gave me a second gown to use as a "cape" and cover that gap. I went for a walk, two laps around the floor I was on. Before he left for the night, he helped me put shorts on, so I wouldn't need to put the cape back on. The nurse then hooked my legs back up, and gave me my oxy and tylenol to take orally.
I was shocked. I was awake for a little more than two hours after a surgery that drastically changed the size of my stomach, and here these people were telling me to take drugs orally. They gave me water and the pills, and I took them. Immediatley I started dry heaving, but nothing produced and the feeling passed. A few minutes later I took another sip without any trouble.
And I quickly fell asleep.
Overnight
This was the four hour pattern I went through the whole night
6:30am
I was woken up by two surgeons to check my incisions and ask how my night went. The nurse said I was training for a marathon all night. Right after the surgeons left, the phlebotomist came in to take blood.
9:00am
When my mom came back the next day (dad and hubby had to work), I was walking when she got there. She literally could not believe it.
I'm going to stop the timestamps here, as the day filled with activity. I had a dietician come in to visit and remind me how important the post operative diet is. At this point, I had only had water, and Vitamin Water Zero, and I knew how important protein shakes were, so I asked for a protein shake to make sure I was okay drinking that before my discharge. The dietician helped me out by getting me a protein shake and made it for me. I had no issue getting this protein down.
Another surgeon also stopped by, and apologized for my surgeon as she was stuck in hellish traffic (by this point I had heard how bad traffic was from a few nurses and my mom). She stressed what the dietician had already said, and was willing to answer any questions. She had also heard I was up and about all night and confirmed I would be going home some time today. A case manager stopped by to ask me questions about my home life. She wanted to make sure I had support, asked if there were stairs, if anyone hurts me at home, etc.
Finally, the head nurse came in to start the discharge process. She had a whole pile of information she had to go through before I could leave, but most of it I knew already. My mom was told to go and get the car and bring it to a certain door, and I would meet her there as they had to wheel me out.
And just like that at about 1:00pm, about 24 hours after being rolled into the OR, Johns Hopkins Bayview was in the rear view mirror.
The first thing I had to do this day was re-wipe myself using the instructions from my pre-op appointment. Since part of this involved my back, I woke up before my husband left for an appointment to help me out. I put on a new set of clothes, and went to bed.
8:15am
I woke up again and drank a bottle of Gatorade given to me from the pre-op appointment. I was told to have this done by 2 hours prior to my appointed arrival time of 10:30am. I got up, made sure everything I needed was in my bag, and my parents were due to arrive at about 9:30am to bring me.
In my bag, I packed:
2 pairs of underwear
2 pairs of comfy pajama or workout shorts
2 t-shirts
iPad
Charger (extra long)
Yarn and a crochet hook
Folder with all of my papers I got so far
Wallet
A hoodie in case I got cold
I wore comfortable clothes to the hospital. Something worth noting was that all of the clothes I brought were clothes I wouldn't mind losing. I kept the charger, my phone, iPad, and wallet in a place where someone would not easily be able to sneak in and grab them. Everything else stayed out of arms reach on a windowsill.
10:30am
We arrived at the hospital a few minutes early but soon enough they brought me into the back. First thing was first, they needed to make sure I wasn't pregnant. I remembered not to pee from the gatorade knowing this was coming, so I gave them my sample and came up negative. I changed into the hospital gown, and got my final pre-surgical weight.
Then, I got my first of 63 Lovenox shots that I would get or self-administer over the next 30 days. The nurse put a motion sickness patch behind my ear to help with nausea, and took a couple of tubes for testing. Then, they started the IV and hooked me up.
At that point my parents and husband were allowed to rejoin me. I was by far the least nervous person in the "room" if that's what you want to call it. It was probably about 11:30am by this time. I was due to go in at 12:30pm. Then the parade of medical professionals started. I don't remember the order, but that's probably not important. The surgeon stopped by to answer any questions my family had and I signed a consent for the surgery. The anesthesiologist stopped by to see how much I could open my mouth, and confirm what he already knew about me. Another anesthesiologist stopped by (there were two on the team) to introduce herself, and its a good thing she did because she was who I really talked to once they rolled me into the OR.
At around 1:00pm, the team came out to take me back. I gave my glasses and phone to my husband (taking off my glasses is my least favorite part of any procedure). I got rolled into the OR and shifted myself onto the table. The anesthesiologist got me positioned and explained that they have found that just a few minutes of CPAP therapy has proven to help patients going into surgery. The OR nurse strapped my legs into machines that pumped air into stockings to prevent blood clots. A few minutes passed by as they got me ready, and suddenly the time came where they instructed me that I would taste a metallic taste, smell something metallic, and possibly feel a burning sensation at the IV point.
5:35pm
The next thing I remember is waking up in the Post Anesthesia Care Unit (PACU) and the first feeling I felt was absolute nausea. A nurse was right by me and she was able to push Zofran to help with the nausea and was able to call out to my family that they could come back. In a few minutes I was reunited with my glasses (yay!) and they held me there for about 2 hours as I got more and more aware. The PACU is the only place I got inject-able pain management, but my pain was only at about a 5/10. My nausea on the other hand needed a second type of drug to finally get controlled.
7:45pm
Finally, a room became available and they rolled me up. For context of how well I was doing pain-wise, I was told immediately that I could have 10mg of oxy if I wanted. But I wanted to walk and use the rest room first. It took my husband and a nurse to get me out of bed, and I walked to the bathroom. I was able to do everything behind the privacy of a bathroom door, which was unexpected. My husband however had to help me put my underwear on. Once that was on, they gave me a second gown to use as a "cape" and cover that gap. I went for a walk, two laps around the floor I was on. Before he left for the night, he helped me put shorts on, so I wouldn't need to put the cape back on. The nurse then hooked my legs back up, and gave me my oxy and tylenol to take orally.
I was shocked. I was awake for a little more than two hours after a surgery that drastically changed the size of my stomach, and here these people were telling me to take drugs orally. They gave me water and the pills, and I took them. Immediatley I started dry heaving, but nothing produced and the feeling passed. A few minutes later I took another sip without any trouble.
And I quickly fell asleep.
Overnight
This was the four hour pattern I went through the whole night
- Oxy
- 90 minute nap
- Slow wake up
- Called nurse to disconnect my legs
- Walk
- Play on phone
- Repeat list
6:30am
I was woken up by two surgeons to check my incisions and ask how my night went. The nurse said I was training for a marathon all night. Right after the surgeons left, the phlebotomist came in to take blood.
9:00am
When my mom came back the next day (dad and hubby had to work), I was walking when she got there. She literally could not believe it.
I'm going to stop the timestamps here, as the day filled with activity. I had a dietician come in to visit and remind me how important the post operative diet is. At this point, I had only had water, and Vitamin Water Zero, and I knew how important protein shakes were, so I asked for a protein shake to make sure I was okay drinking that before my discharge. The dietician helped me out by getting me a protein shake and made it for me. I had no issue getting this protein down.
Another surgeon also stopped by, and apologized for my surgeon as she was stuck in hellish traffic (by this point I had heard how bad traffic was from a few nurses and my mom). She stressed what the dietician had already said, and was willing to answer any questions. She had also heard I was up and about all night and confirmed I would be going home some time today. A case manager stopped by to ask me questions about my home life. She wanted to make sure I had support, asked if there were stairs, if anyone hurts me at home, etc.
Finally, the head nurse came in to start the discharge process. She had a whole pile of information she had to go through before I could leave, but most of it I knew already. My mom was told to go and get the car and bring it to a certain door, and I would meet her there as they had to wheel me out.
And just like that at about 1:00pm, about 24 hours after being rolled into the OR, Johns Hopkins Bayview was in the rear view mirror.
Thursday, July 20, 2017
May 30, 2017: Day and Night before surgery
May 30 was the day before the big day. As mentioned in the nutrition post, I was to follow a "full liquid" diet this day to not put much more into my intestines.
I was able to work from home this day and my husband had a day off. On his days off, he teaches ukulele lessons, so the house had people in and out all day which was great to break up the day. Our pastor also stopped by.
For food that I ate that day, I basically followed the liver shrink diet with a protein shake for dinner instead of a somewhat normal meal.
As I got ready for bed, I had specific instructions. I was to take a normal shower, then not apply any lotions or powders, then wait two hours, and wipe my arms, neck, and torso in a specific fashion using wipes provided at my pre-op. I was also to clean my belly button out with a cotton swab.
My instructions were also to sleep on clean sheets and wearing clean clothes this night as well. And, without pets in the room, which both kitties were NOT happy about. We had kicked them out a few nights earlier to make it less traumatic for us.
Then, I slept. Probably better than my husband.
Next up: Surgery day and joining the loser's bench
I was able to work from home this day and my husband had a day off. On his days off, he teaches ukulele lessons, so the house had people in and out all day which was great to break up the day. Our pastor also stopped by.
For food that I ate that day, I basically followed the liver shrink diet with a protein shake for dinner instead of a somewhat normal meal.
As I got ready for bed, I had specific instructions. I was to take a normal shower, then not apply any lotions or powders, then wait two hours, and wipe my arms, neck, and torso in a specific fashion using wipes provided at my pre-op. I was also to clean my belly button out with a cotton swab.
My instructions were also to sleep on clean sheets and wearing clean clothes this night as well. And, without pets in the room, which both kitties were NOT happy about. We had kicked them out a few nights earlier to make it less traumatic for us.
Then, I slept. Probably better than my husband.
Next up: Surgery day and joining the loser's bench
July 19, 2017: Seven Weeks
Seven weeks down!! One more week until vegetables and I've never been more excited for a salad. In reality it will be one week and a few days since we're going away, but I'll be sure to pack Zofran just in case.
A rather uneventful day all things considered, but busy. And, I had to end the day making deviled eggs for a potluck at work.
Anyway, down to business:
Food journal:
Breakfast:
Medium DD Iced Coffee w/Skim Milk
Pure Protein w/water
Mid Morning Snack:
Oikos Triple zero
Lunch:
Single egg salad
Afternoon snack:
Applesauce packet
After-workout snack:
Quest bar
Dinner:
Jerky (1 serving)
Oikos Triple Zero
Workout journal:
Back workout (PE@PF)
Bent over rows 4x12 each arm. Set 1: 10lbs, Sets 2-3: 15lbs, Set 4: 20lbs
Slight bend rows with barbell 4x12@30lbs
Pull downs 4x12 at Set 1: 40lbs Sets 2-4: 55lbs
Single arm standing pulls (cable) 4x12 each arm @ 25lbs
Here's where I ask you for help, do you understand what I'm saying when I describe my workouts? If not I'll try to make a GIF or find a link or something.
A rather uneventful day all things considered, but busy. And, I had to end the day making deviled eggs for a potluck at work.
Anyway, down to business:
Food journal:
Breakfast:
Medium DD Iced Coffee w/Skim Milk
Pure Protein w/water
Mid Morning Snack:
Oikos Triple zero
Lunch:
Single egg salad
Afternoon snack:
Applesauce packet
After-workout snack:
Quest bar
Dinner:
Jerky (1 serving)
Oikos Triple Zero
Workout journal:
Back workout (PE@PF)
Bent over rows 4x12 each arm. Set 1: 10lbs, Sets 2-3: 15lbs, Set 4: 20lbs
Slight bend rows with barbell 4x12@30lbs
Pull downs 4x12 at Set 1: 40lbs Sets 2-4: 55lbs
Single arm standing pulls (cable) 4x12 each arm @ 25lbs
Here's where I ask you for help, do you understand what I'm saying when I describe my workouts? If not I'll try to make a GIF or find a link or something.
Wednesday, July 19, 2017
May 2017: Pre-op appointments
After I finished all of my pre-surgical requirements, I let the office manager for my doctor know so she could submit to insurance. Besides the initial appointment, I had the following to complete:
Just a few days later, I was told my surgery would be May 31. Less than a month away. I literally couldn't believe it and all the sudden everything was in motion. The office sent me a pile of papers of all of my appointments before and after surgery along with a reminder about the pre-surgical diet, and reminding me to get a pre-op with my PCP, which would include a blood draw, and a chest x-ray.
For the sake of readers who don't actually know me, my PCP does not actually have an x-ray on premises. So one day I had the afternoon off for a clinical trial I'm in (its super cool and I can't wait to share about that), I asked her to send the request in for my x-ray so I could get it while I had time off.
Chest x-ray...check
I had my visit with my PCP lined up for a few days later. She looked at the chest x-ray with me and basically gave me a physical including an EKG. It was uneventful but exciting because after months, this meant I was getting very close. After the EKG I got my blood drawn, so I was done with that step.
Finally I had to go see the surgeon for a pre-op. I asked why, and they said I had not been to the clinic hours since my initial visit in January and there was special stuff they had to give me. I went to the visit and the nurse practitioner on my surgeon's team was thrilled with all the progress I made (by this point I was teetering at 35lbs lost since January). She gave me two bottles of gatorade, special pre-surgical wipes, and a pretty blue bag. More details on all of those (including the pretty blue bag) later.
That was May 19. Next up was the big day.
I write this post because I see a lot of people online getting very nervous about their pre-op and the bottom line is, its just a physical. The doctors on your team need to know as much as they can about what's going on in your body before they put it through the incredible stress of surgery. For example, every other provider I've met claims I'm an asthmatic. I personally think I just get sick badly in my lungs for a longer period than others (something my cat Finn must have gotten from me), but the chest x-ray showed literally in black and white, something resembling asthma. Seeing as someone, namely the anesthesiologist, was going to be controlling my breathing for about four hours, this is an important detail.
Next up: May 30, 2017
- Four appointments with my Primary Care Provider known from here out as PCP (or three appointments at JH Bayview)
- An appointment with a Nutritionist (here I covered vitamins and here I covered food)
- An appointment with a Psychiatrist
- Attend a Group Support session
- Have an EGD done
- Have a sleep study done
Just a few days later, I was told my surgery would be May 31. Less than a month away. I literally couldn't believe it and all the sudden everything was in motion. The office sent me a pile of papers of all of my appointments before and after surgery along with a reminder about the pre-surgical diet, and reminding me to get a pre-op with my PCP, which would include a blood draw, and a chest x-ray.
For the sake of readers who don't actually know me, my PCP does not actually have an x-ray on premises. So one day I had the afternoon off for a clinical trial I'm in (its super cool and I can't wait to share about that), I asked her to send the request in for my x-ray so I could get it while I had time off.
Chest x-ray...check
I had my visit with my PCP lined up for a few days later. She looked at the chest x-ray with me and basically gave me a physical including an EKG. It was uneventful but exciting because after months, this meant I was getting very close. After the EKG I got my blood drawn, so I was done with that step.
Finally I had to go see the surgeon for a pre-op. I asked why, and they said I had not been to the clinic hours since my initial visit in January and there was special stuff they had to give me. I went to the visit and the nurse practitioner on my surgeon's team was thrilled with all the progress I made (by this point I was teetering at 35lbs lost since January). She gave me two bottles of gatorade, special pre-surgical wipes, and a pretty blue bag. More details on all of those (including the pretty blue bag) later.
That was May 19. Next up was the big day.
I write this post because I see a lot of people online getting very nervous about their pre-op and the bottom line is, its just a physical. The doctors on your team need to know as much as they can about what's going on in your body before they put it through the incredible stress of surgery. For example, every other provider I've met claims I'm an asthmatic. I personally think I just get sick badly in my lungs for a longer period than others (something my cat Finn must have gotten from me), but the chest x-ray showed literally in black and white, something resembling asthma. Seeing as someone, namely the anesthesiologist, was going to be controlling my breathing for about four hours, this is an important detail.
Next up: May 30, 2017
April 26, 2017: Nutrition Visit (Food)
In a previous post about nutrition, I realized this single visit was a huge amount of information. I covered vitamins previously with the promise to cover nutrition.
I feel now is an appropriate time to again remind readers that I'm a patient, not a doctor or dietician. I have a history degree, not a medical degree. I do however read everything put in front of me, which I highly recommend, and I take advice from outside of my surgical program with a big grain of salt.
I'm going to break up the nutrition by day and week and only until the point I'm at now. I'm sure I'll have nutrition updates as my diet expands.
Two weeks prior (really thirteen days, see below): Pre-surgical "Liver Shrink" Diet
A little known fact about most obese individuals is that their livers are swollen with fatty liver disease. It's a medical fact of life.
In order to perform a successful laparoscopic surgery, the liver must be as small as it possibly can be. In order to do this, surgeons assigns a special pre-surgical diet.
Starting two weeks out, my diet looked like this:
Breakfast:
Protein Shake
Mid morning snack:
Fat free yogurt or fruit
Lunch:
Protein Shake
Snack:
Fat free yogurt or fruit (usually whatever I didn't have earlier)
Dinner:
3-4oz of lean meat/fish with 1c. steamed veggies OR 1c. salad with 1 TBSP of low fat dressing
It was hard at first, I'm not going to lie. But I knew that this was still A LOT of food compared to what my life was going to look like post op. Also, I knew following this diet to the letter was the difference between a laparoscopic surgery and an open surgery. Open surgeries require a much longer recovery time.
One day prior: Full Liquid Diet
One day before it's time to make sure you have as little in your digestive system as possible. This day looked very similar to the previous two weeks, but just yogurt twice instead of fruit, and dinner was also a protein shake.
One week after: Full liquid diet
For the full liquid diet, there were more options that one would think. I was able to have yogurt, ricotta cheese, cottage cheese, pudding, jello, and frozen treats such as sugar free popsicles and fudge pops.
The most important parts of this week is to get the 60-80g of protein in daily and to get at least 64oz of water daily. This would become quite the challenge, but it should literally be the only two things your focusing on.
Weeks two, three, and four: Puree
This was an annoying part of the diet. Honestly I just bought baby food for the most part to get veggies and fruit in. There were also little baby food treats that I treated myself to. For meat, I discovered that chicken did not work for me, but ground beef that was then put into a food processor worked great. Tuna (pureed) also worked great.
Weeks five, six, seven, eight: Soft foods
This is my current place. I can basically eat anything except for the skins of vegetables and fruits, rice, and some other stuff that doesn't come to mind but I don't miss it. Take a look at any of my food journals to get an idea of what I'm doing these days.
I will say this, through this whole process, foods should be fat free or low fat as much as you can. A little fat is healthy to get into a diet daily, but do look for the lower fat items when given options.
Next up: Pre-op
I feel now is an appropriate time to again remind readers that I'm a patient, not a doctor or dietician. I have a history degree, not a medical degree. I do however read everything put in front of me, which I highly recommend, and I take advice from outside of my surgical program with a big grain of salt.
I'm going to break up the nutrition by day and week and only until the point I'm at now. I'm sure I'll have nutrition updates as my diet expands.
Two weeks prior (really thirteen days, see below): Pre-surgical "Liver Shrink" Diet
A little known fact about most obese individuals is that their livers are swollen with fatty liver disease. It's a medical fact of life.
In order to perform a successful laparoscopic surgery, the liver must be as small as it possibly can be. In order to do this, surgeons assigns a special pre-surgical diet.
Starting two weeks out, my diet looked like this:
Breakfast:
Protein Shake
Mid morning snack:
Fat free yogurt or fruit
Lunch:
Protein Shake
Snack:
Fat free yogurt or fruit (usually whatever I didn't have earlier)
Dinner:
3-4oz of lean meat/fish with 1c. steamed veggies OR 1c. salad with 1 TBSP of low fat dressing
It was hard at first, I'm not going to lie. But I knew that this was still A LOT of food compared to what my life was going to look like post op. Also, I knew following this diet to the letter was the difference between a laparoscopic surgery and an open surgery. Open surgeries require a much longer recovery time.
One day prior: Full Liquid Diet
One day before it's time to make sure you have as little in your digestive system as possible. This day looked very similar to the previous two weeks, but just yogurt twice instead of fruit, and dinner was also a protein shake.
One week after: Full liquid diet
For the full liquid diet, there were more options that one would think. I was able to have yogurt, ricotta cheese, cottage cheese, pudding, jello, and frozen treats such as sugar free popsicles and fudge pops.
The most important parts of this week is to get the 60-80g of protein in daily and to get at least 64oz of water daily. This would become quite the challenge, but it should literally be the only two things your focusing on.
Weeks two, three, and four: Puree
This was an annoying part of the diet. Honestly I just bought baby food for the most part to get veggies and fruit in. There were also little baby food treats that I treated myself to. For meat, I discovered that chicken did not work for me, but ground beef that was then put into a food processor worked great. Tuna (pureed) also worked great.
Weeks five, six, seven, eight: Soft foods
This is my current place. I can basically eat anything except for the skins of vegetables and fruits, rice, and some other stuff that doesn't come to mind but I don't miss it. Take a look at any of my food journals to get an idea of what I'm doing these days.
I will say this, through this whole process, foods should be fat free or low fat as much as you can. A little fat is healthy to get into a diet daily, but do look for the lower fat items when given options.
Next up: Pre-op
July 18, 2017: Six weeks, six days
Today was a much better day than yesterday. Probably mostly because I avoided pit beef...
A big change I made today was I started using MyFitnessPal (MFP) over Baritastic for tracking food. This is simply because I can leave MFP up at my desk all day on the monitor and add stuff. Baritastic depends on data usage on my phone, which is spotty at best at work.
I ran three miles in 34 minutes at lunch time and I'm getting to the point where I may need to start showering at lunch time. Gross, but could affect the routine I've been working at. After work I did two PE@PF classes (Chest and PF360), then spent about two hours on the pool deck for tryouts. Soooo I basically was a gross sweaty mess from about 11:30am til 9pm when I finally took a shower.
Something interesting that happened as a result of this change was that at the end of the day, I can "Complete Entry" and it will give me a estimate of my weight 5 weeks from today if every day were like today. The weight popped up, and it was about 30 pounds less than I am right now, but I am seeing myself at 30 lbs higher than I am right now.
If anyone is interested, I am updating a lot on Instagram, and I put a side by side up with a picture from 2012 and the difference in unreal. Check me out @Jackienelli
Food Journal:
Breakfast:
Pure Protein with water
Mid Morning:
Oikos Triple Zero
Lunch:
Single egg salad
Afternoon Snack:
Applesauce packet
After workout snack:
Quest bar
Dinner:
Bubba burger patty (nothing on it)
Workout Journal:
11:45-12:20: 34 minutes on elliptical at level 1. Ran 3 miles
3:30-4:00: Chest workout
Flat chest press one arm at a time 4x12 (each arm) w/7.5 lbs dumbbell
Incline chest press both arms 4x12 w/7.5lbs
Incline fly both arms 3x10 w/7.5lbs
Overhead press 3x10 w/single 15lbs dumbbell with 2 hands
4:00-4:30: PF360 (each activity is done for a minute with 30 sec. rest between, repeated circuit a second time with the wall sit happening a third time)
Wall squat while throwing 6lb medicine ball at trampoline
Mountain climbers
Weighted step ups (step on level 2, first round with 10 lbs, second round with 20 lbs)
Ropes, squatting, 10 sec w/arms together, 10 sec w/arms alternating
TPX suspension squats
Modified one leg dead lifts (most bearing on back) (first round 15 lb kettlebell, second w/20lbs)
Overhead tricep pulls (17.5lbs)
A big change I made today was I started using MyFitnessPal (MFP) over Baritastic for tracking food. This is simply because I can leave MFP up at my desk all day on the monitor and add stuff. Baritastic depends on data usage on my phone, which is spotty at best at work.
I ran three miles in 34 minutes at lunch time and I'm getting to the point where I may need to start showering at lunch time. Gross, but could affect the routine I've been working at. After work I did two PE@PF classes (Chest and PF360), then spent about two hours on the pool deck for tryouts. Soooo I basically was a gross sweaty mess from about 11:30am til 9pm when I finally took a shower.
Something interesting that happened as a result of this change was that at the end of the day, I can "Complete Entry" and it will give me a estimate of my weight 5 weeks from today if every day were like today. The weight popped up, and it was about 30 pounds less than I am right now, but I am seeing myself at 30 lbs higher than I am right now.
If anyone is interested, I am updating a lot on Instagram, and I put a side by side up with a picture from 2012 and the difference in unreal. Check me out @Jackienelli
Food Journal:
Breakfast:
Pure Protein with water
Mid Morning:
Oikos Triple Zero
Lunch:
Single egg salad
Afternoon Snack:
Applesauce packet
After workout snack:
Quest bar
Dinner:
Bubba burger patty (nothing on it)
Workout Journal:
11:45-12:20: 34 minutes on elliptical at level 1. Ran 3 miles
3:30-4:00: Chest workout
Flat chest press one arm at a time 4x12 (each arm) w/7.5 lbs dumbbell
Incline chest press both arms 4x12 w/7.5lbs
Incline fly both arms 3x10 w/7.5lbs
Overhead press 3x10 w/single 15lbs dumbbell with 2 hands
4:00-4:30: PF360 (each activity is done for a minute with 30 sec. rest between, repeated circuit a second time with the wall sit happening a third time)
Wall squat while throwing 6lb medicine ball at trampoline
Mountain climbers
Weighted step ups (step on level 2, first round with 10 lbs, second round with 20 lbs)
Ropes, squatting, 10 sec w/arms together, 10 sec w/arms alternating
TPX suspension squats
Modified one leg dead lifts (most bearing on back) (first round 15 lb kettlebell, second w/20lbs)
Overhead tricep pulls (17.5lbs)
Tuesday, July 18, 2017
April 26, 2017: Nutrition Visit (Vitamins)
Nutrition is the biggest, longest part of this pre-surgical process.
It also has the potential to be the most confusing.
Hopkins' program is a single, 90 minute meeting with the nutritionist about a month before surgery. I made the appointment in February assuming my PCP visits would stay on schedule. Sure enough, everything stayed on track and I was able to have my appointment.
There was a book that the nutritionist went through, but it can be summed up into two parts: vitamins, and food. This post will focus on vitamins.
Vitamins were deceptively easy. I have decided not to talk numbers as to not confuse any readers from what your program's nutritionist may have said. When in doubt, trust your own nutritionist and now some power-hungry blogger.
I will say this about vitamins that I have found other patients in other programs concur with. First, there is no swallowing of vitamins for the first 6 months or so, so everything is chewable. Also, no gummies that are so popular right now. The new gastric bypass stomach cannot handle a gummy.
I was given options with regards to brand, and she said if I found a new vitamin, to look at the goals she was giving me that day, and make sure it lined up. She also gave me some samples to help my purchasing decision.
This is what I've decided to take (again, this works for me, it might not work for you):
By 6:30am:
Celebrate Calcium Plus 500
By 8:30am but no sooner than 2 hours after first pill:
Celebrate Calcium Plus 500
By 2:00pm but no sooner than 2 hours after second pill:
Celebrate Calcium Plus 500
In the evening, at least 2 hours after final calcium pill:
Celebrate Multivitamin with 60 Iron (2)
I was told that Calcium Citrate is harder to purchase in regular stores, so I decided to go through Celebrate for those. I have since found out that a chewable calcium citrate is sold at WalMart and I have yet to investigate for myself.
I decided to buy Celebrate for the Multivitamin as well, because Celebrate was the complete package, including Biotin for hair, and my daily iron. Since starting, sometimes the multivitamin makes me really nauseous. For my next order, I decided to separate the multivitamin from the iron to try to help this nausea. The total cost for my first three months of vitamins was $96.
A quick note on my iron intake: bypass patients require a higher amount daily as do pre-menopausal women. So I won on both fronts.
In the past couple of months, I have heard so many stories about vitamins. I'm glad my vitamins are so streamlined, even when I do separate the multivitamin from the iron. Also, while $96 feels like a big purchase when I buy it, it lasted me ninety days, so that's a hair more than a dollar a day.
I ordered the next batch and it went up to $121, but it might be worth it to not end my day with sometimes overwhelming nausea.
Successful vitamin intake has shown to prevent hair falling out, bone issues, and more successful pregnancies than those who do not take vitamins. I also ordered this oversize pill holder on Amazon that has been perfect for me. I pop the "day" box out and carry it with me all day.
It also has the potential to be the most confusing.
Hopkins' program is a single, 90 minute meeting with the nutritionist about a month before surgery. I made the appointment in February assuming my PCP visits would stay on schedule. Sure enough, everything stayed on track and I was able to have my appointment.
There was a book that the nutritionist went through, but it can be summed up into two parts: vitamins, and food. This post will focus on vitamins.
Vitamins were deceptively easy. I have decided not to talk numbers as to not confuse any readers from what your program's nutritionist may have said. When in doubt, trust your own nutritionist and now some power-hungry blogger.
I will say this about vitamins that I have found other patients in other programs concur with. First, there is no swallowing of vitamins for the first 6 months or so, so everything is chewable. Also, no gummies that are so popular right now. The new gastric bypass stomach cannot handle a gummy.
I was given options with regards to brand, and she said if I found a new vitamin, to look at the goals she was giving me that day, and make sure it lined up. She also gave me some samples to help my purchasing decision.
This is what I've decided to take (again, this works for me, it might not work for you):
By 6:30am:
Celebrate Calcium Plus 500
By 8:30am but no sooner than 2 hours after first pill:
Celebrate Calcium Plus 500
By 2:00pm but no sooner than 2 hours after second pill:
Celebrate Calcium Plus 500
In the evening, at least 2 hours after final calcium pill:
Celebrate Multivitamin with 60 Iron (2)
I was told that Calcium Citrate is harder to purchase in regular stores, so I decided to go through Celebrate for those. I have since found out that a chewable calcium citrate is sold at WalMart and I have yet to investigate for myself.
I decided to buy Celebrate for the Multivitamin as well, because Celebrate was the complete package, including Biotin for hair, and my daily iron. Since starting, sometimes the multivitamin makes me really nauseous. For my next order, I decided to separate the multivitamin from the iron to try to help this nausea. The total cost for my first three months of vitamins was $96.
A quick note on my iron intake: bypass patients require a higher amount daily as do pre-menopausal women. So I won on both fronts.
In the past couple of months, I have heard so many stories about vitamins. I'm glad my vitamins are so streamlined, even when I do separate the multivitamin from the iron. Also, while $96 feels like a big purchase when I buy it, it lasted me ninety days, so that's a hair more than a dollar a day.
I ordered the next batch and it went up to $121, but it might be worth it to not end my day with sometimes overwhelming nausea.
Successful vitamin intake has shown to prevent hair falling out, bone issues, and more successful pregnancies than those who do not take vitamins. I also ordered this oversize pill holder on Amazon that has been perfect for me. I pop the "day" box out and carry it with me all day.
July 17, 2017: Six weeks, five days
Today was one of those days I like to forget happen from time to time.
I was working from home and went to the gym for a 30 minute circuit at lunch time, and when I got home I decided to have the leftover pit beef from yesterday. Big mistake.
As I was eating it, I was thinking how something didn't feel right, and for good reason. I was vomiting up the beef from about 12:30 to 2 in the afternoon.
While I'm vomiting, keep in mind that I can't drink. So that was an hour and a half, plus the time to eat AND the half hour waiting period not drinking. That is a long time for me to go without any water.
Finally everything passed and I felt better. I had a protein bar for dinner and went out crocheting with some local ladies. While out at Starbucks with them I had two hot teas.
Food Journal:
Breakfast:
Premier protein (1/2 scoop) with water
Mid morning Snack:
No Sugar Added Fudge Pops
Lunch:
3oz pit beef 😷
Afternoon snack:
Quest protein chips
Dinner:
Quest blueberry muffin protein bar
Evening snack (so I didn't vomit up my multivitamin):
GF Matzo
I was working from home and went to the gym for a 30 minute circuit at lunch time, and when I got home I decided to have the leftover pit beef from yesterday. Big mistake.
As I was eating it, I was thinking how something didn't feel right, and for good reason. I was vomiting up the beef from about 12:30 to 2 in the afternoon.
While I'm vomiting, keep in mind that I can't drink. So that was an hour and a half, plus the time to eat AND the half hour waiting period not drinking. That is a long time for me to go without any water.
Finally everything passed and I felt better. I had a protein bar for dinner and went out crocheting with some local ladies. While out at Starbucks with them I had two hot teas.
Food Journal:
Breakfast:
Premier protein (1/2 scoop) with water
Mid morning Snack:
No Sugar Added Fudge Pops
Lunch:
3oz pit beef 😷
Afternoon snack:
Quest protein chips
Dinner:
Quest blueberry muffin protein bar
Evening snack (so I didn't vomit up my multivitamin):
GF Matzo
Monday, July 17, 2017
March 9, 2017: Group Support Session
Another item on my list to attend was a group support session at Johns Hopkins. They are offered twice monthly, and I'll admit I put it off. I didn't know what I would learn from a room full of people when I have doctors and the internet to look to. I didn't need another "Weight Watchers" type meeting.
I walked in expecting to just check my box, but what I found was so much more.
I came to find out that each session (held twice monthly) has a theme, such as surgical, nutritional, and behavioral. Each are led by a representative from that department.
At first I was hesitant to go (although I knew I had to), because I've been to enough meetings about losing weight or trying to lose weight. This was a different approach, a surgical approach, and I didn't see how a meeting would help.
I was so wrong.
In this usually full room, it is full of people that share a journey with me. There isn't anything said perceived as too weird ("Does anyone else have really smelly gas all the sudden?"). Everyone in the room can either guide you down the road, or you will become a role model for someone else in the room. I have several friends that went through the surgery, and this room has become a room full of friends no matter how many times they have walked through the door.
I can always tell the first timers, feeling the room out seeing if the size of the attendees matches their expectations of the meeting. As the meeting starts, we all introduce ourselves and say if we're pre or post op, what type of surgery, and how much we have lost (if applicable). The first time I went I took tons of notes, but now I listen. And that has been so much help.
Don't get me wrong, I have an amazing support system. My husband, parents, and in-laws are all local and unbelievably supportive and have made sacrifices through this journey. I also have friends an coworkers who are supportive and hear about what I'm going through.
It's not the most convenient place for me, its about a 40 minute drive from my house twice a month after a day of work. But I make the time to go to these meetings because they are so supportive.
Next appointment: Nutrition.
I walked in expecting to just check my box, but what I found was so much more.
I came to find out that each session (held twice monthly) has a theme, such as surgical, nutritional, and behavioral. Each are led by a representative from that department.
At first I was hesitant to go (although I knew I had to), because I've been to enough meetings about losing weight or trying to lose weight. This was a different approach, a surgical approach, and I didn't see how a meeting would help.
I was so wrong.
In this usually full room, it is full of people that share a journey with me. There isn't anything said perceived as too weird ("Does anyone else have really smelly gas all the sudden?"). Everyone in the room can either guide you down the road, or you will become a role model for someone else in the room. I have several friends that went through the surgery, and this room has become a room full of friends no matter how many times they have walked through the door.
I can always tell the first timers, feeling the room out seeing if the size of the attendees matches their expectations of the meeting. As the meeting starts, we all introduce ourselves and say if we're pre or post op, what type of surgery, and how much we have lost (if applicable). The first time I went I took tons of notes, but now I listen. And that has been so much help.
Don't get me wrong, I have an amazing support system. My husband, parents, and in-laws are all local and unbelievably supportive and have made sacrifices through this journey. I also have friends an coworkers who are supportive and hear about what I'm going through.
It's not the most convenient place for me, its about a 40 minute drive from my house twice a month after a day of work. But I make the time to go to these meetings because they are so supportive.
Next appointment: Nutrition.
March 3, 2017: Gynecologist
When undergoing the process to get such a life-changing surgery, you never know what doctors will be on your to-do list.
At the first appointment, another item that was brought up was the need to change my method of birth control. I was on the tried and true hormonal pill option, but the extra hormones increase the risk of blood clots. Hospitals as a whole have increased concern about blood clots, and obesity is one strong factor, so I could understand why they required me to change.
Second, it is suggested to not get pregnant for 18 months after surgery, so getting a non-hormonal implant increased the effectiveness of pregnancy prevention. It takes out the human error of remembering to take the pill at exactly the same time every day for most effectiveness.
Finally, dropping so much weight so quickly makes women particularly fertile. So in order to reach that 18 month goal, patients need to be very careful.
I made an appointment with a new gynecologist, because my current one decided to leave her practice. Luckily, I was able to stress the importance of getting the ball rolling with this appointment so they were able to get me in pretty quickly.
At the appointment, we discussed my options. One was an IUD such as Mirena. I was not a fan of Mirena or other IUDs as I did not want another pain to worry about. Gastric bypasses does affect your intestines, and there are all sorts of things to worry about in that regard (hernias, blockages, etc). I wanted to not have to go through a longer process to arrive at a potential diagnosis for lower abdominal pain.
Another option was a non-hormonal birth control pill, but she told me she would not recommend that to me. It is proven to not be effective in obese women.
Finally there was the Nexplanon insert. It is inserted into the upper arm in an quick, in-office procedure. It took nearly two months from the appointment to get Nexplanon inserted, and it ended up happening thirty days before surgery.
To get the Nexplanon inserted was relatively painless, and my experience didn't even involve much bruising. The doctor numbed the area, and then inserted it, and voila! I'm good for up to three years. I am told that for most women there is not much time needed between removing the implant and being fertile again.
Next appointment: Support Group
At the first appointment, another item that was brought up was the need to change my method of birth control. I was on the tried and true hormonal pill option, but the extra hormones increase the risk of blood clots. Hospitals as a whole have increased concern about blood clots, and obesity is one strong factor, so I could understand why they required me to change.
Second, it is suggested to not get pregnant for 18 months after surgery, so getting a non-hormonal implant increased the effectiveness of pregnancy prevention. It takes out the human error of remembering to take the pill at exactly the same time every day for most effectiveness.
Finally, dropping so much weight so quickly makes women particularly fertile. So in order to reach that 18 month goal, patients need to be very careful.
I made an appointment with a new gynecologist, because my current one decided to leave her practice. Luckily, I was able to stress the importance of getting the ball rolling with this appointment so they were able to get me in pretty quickly.
At the appointment, we discussed my options. One was an IUD such as Mirena. I was not a fan of Mirena or other IUDs as I did not want another pain to worry about. Gastric bypasses does affect your intestines, and there are all sorts of things to worry about in that regard (hernias, blockages, etc). I wanted to not have to go through a longer process to arrive at a potential diagnosis for lower abdominal pain.
Another option was a non-hormonal birth control pill, but she told me she would not recommend that to me. It is proven to not be effective in obese women.
Finally there was the Nexplanon insert. It is inserted into the upper arm in an quick, in-office procedure. It took nearly two months from the appointment to get Nexplanon inserted, and it ended up happening thirty days before surgery.
To get the Nexplanon inserted was relatively painless, and my experience didn't even involve much bruising. The doctor numbed the area, and then inserted it, and voila! I'm good for up to three years. I am told that for most women there is not much time needed between removing the implant and being fertile again.
Next appointment: Support Group
July 16, 2017: Six weeks, four days
Sundays are a day I always want to be lazy. It's so easy! We wake up early for church, spend a couple of hours there, grab lunch, and suddenly the lazies set in.
I let the lazies take their run, but I also made sure to have a productive day.
Today I found out that pit beef sits well with me, which was great as I'd been feeling like I could be getting anemic. After the beef induced nap, I went to Planet Fitness and did a 40 minute run there, blowing away my previous long-run record of 32 minutes. I've decided if I keep Fridays as one of my hardest workout days, and Saturdays as a day off, Sunday makes perfect sense to push my cardio limits. Of course, I make this decision as we are about to go away...
Food Journal:
Breakfast:
Premier Protein in Almond Milk
Lunch:
3oz Pit beef (leftovers for days!!)
GF Matzo (about an hour after pit beef)
Dinner:
Banza chickpea pasta with Wegmans tomato basil sauce
Snack:
Remaining Halo Top
I let the lazies take their run, but I also made sure to have a productive day.
Today I found out that pit beef sits well with me, which was great as I'd been feeling like I could be getting anemic. After the beef induced nap, I went to Planet Fitness and did a 40 minute run there, blowing away my previous long-run record of 32 minutes. I've decided if I keep Fridays as one of my hardest workout days, and Saturdays as a day off, Sunday makes perfect sense to push my cardio limits. Of course, I make this decision as we are about to go away...
Food Journal:
Breakfast:
Premier Protein in Almond Milk
Lunch:
3oz Pit beef (leftovers for days!!)
GF Matzo (about an hour after pit beef)
Dinner:
Banza chickpea pasta with Wegmans tomato basil sauce
Snack:
Remaining Halo Top
Sunday, July 16, 2017
February 15, 2017: The Sleep Study
As a part of my application for the surgery, I had to write that I had been diagnosed with sleep apnea in 2014. But, the diagnosis did not involve a sleep study, and rather my giant tonsils that were later removed. The surgeon who performed that surgery said that removing the tonsils likely took care of my sleep apnea issues.
At the first appointment, the surgeon said she wanted me to get a sleep study done because of this note from 2014.
The process to get the sleep study was easy enough, and the night of the exam I packed my 'jammies and went in at around 9:00pm. Once in my tiny little room, they told me to mimic my nighttime routine the best I could, which for me includes a shower. After a shower, the technician came in and hooked all the sensors around my head, face, and chest. Part of the paperwork that I signed said if they noticed apnea, they could come in and start me on a CPAP so they would know what machine settings I would need (if necessary). The technician left the room and asked me to follow some instructions ("Blink twice, move your left leg, move your right arm...").
Then comes sleep. Or lack thereof.
Once during the night I managed to take a sensor off so they came in to fix it. And all the sudden it was 5:45am, which is my normal wake up time. I took another shower to get all of the glue out of my hair and by 6:15am I was walking out of clinic.
About two months earlier, my husband had a sleep study and he clearly had an issue with apnea, and sure enough a day after his study we got a phone call that he had severe sleep apnea (over 120 issues in an hour) and they already took it upon themselves to order him a CPAP. So when a few days had passed without a phone call, I was confident that I did not have sleep apnea. A few weeks later I got a paper report in the mail, and there were minor incidents but nothing that was making doctors call me like they had called my husband.
A month after the sleep study, I followed up with a sleep doctor. She started by saying how confused she was about the 2014 "diagnosis" and after a quick physical examination she said I had four incidents in the whole night, and if I felt like my quality of sleep was being affected she would order a CPAP, but she was confident that by losing a little weight I would probably not have any apnea incidents soon.
I am not sure how this would work, but I am curious to see the improvement in my sleeping after surgery. I feel like I'm sleeping better, but I'm also a little more of a metrics nut than I used to be. I love my Fitbit and finding out the quality of my sleep when I wake up.
Next up: Having to change birth control...
At the first appointment, the surgeon said she wanted me to get a sleep study done because of this note from 2014.
The process to get the sleep study was easy enough, and the night of the exam I packed my 'jammies and went in at around 9:00pm. Once in my tiny little room, they told me to mimic my nighttime routine the best I could, which for me includes a shower. After a shower, the technician came in and hooked all the sensors around my head, face, and chest. Part of the paperwork that I signed said if they noticed apnea, they could come in and start me on a CPAP so they would know what machine settings I would need (if necessary). The technician left the room and asked me to follow some instructions ("Blink twice, move your left leg, move your right arm...").
Then comes sleep. Or lack thereof.
Once during the night I managed to take a sensor off so they came in to fix it. And all the sudden it was 5:45am, which is my normal wake up time. I took another shower to get all of the glue out of my hair and by 6:15am I was walking out of clinic.
About two months earlier, my husband had a sleep study and he clearly had an issue with apnea, and sure enough a day after his study we got a phone call that he had severe sleep apnea (over 120 issues in an hour) and they already took it upon themselves to order him a CPAP. So when a few days had passed without a phone call, I was confident that I did not have sleep apnea. A few weeks later I got a paper report in the mail, and there were minor incidents but nothing that was making doctors call me like they had called my husband.
A month after the sleep study, I followed up with a sleep doctor. She started by saying how confused she was about the 2014 "diagnosis" and after a quick physical examination she said I had four incidents in the whole night, and if I felt like my quality of sleep was being affected she would order a CPAP, but she was confident that by losing a little weight I would probably not have any apnea incidents soon.
I am not sure how this would work, but I am curious to see the improvement in my sleeping after surgery. I feel like I'm sleeping better, but I'm also a little more of a metrics nut than I used to be. I love my Fitbit and finding out the quality of my sleep when I wake up.
Next up: Having to change birth control...
July 15, 2017: Six weeks and three days
Remember when I thought it would be a good idea to use my lunch break to take two PE@PF classes? The consequences came yesterday..
Sore abs...sore back...sore legs...
I was up and about pretty early, I went to a swim meet where a lot of my fall/winter swimmers were swimming. Then we went to see the newest Spiderman movie.
As for working out, not much was done yesterday. I was sore and my body was tired.
I had Banza Pasta for the first time since surgery. It's a chikpea based pasta, so no rice or corn is in it at all. It's a little high in carbs but they're complex carbs. I also tried Quest Protein chips for the first time ever. They were a little bland but were a nice change from my standard protein sources.
Food Journal:
Breakfast:
Vega all in one shake
Lunch:
Quest Protein Chips
Snack:
No sugar added Fudge pops
Dinner:
1 serving of Banza Pasta with a half cup of Wegmans Pasta sauce
Dessert:
A third of a pint of Halo Top ice cream
Sore abs...sore back...sore legs...
I was up and about pretty early, I went to a swim meet where a lot of my fall/winter swimmers were swimming. Then we went to see the newest Spiderman movie.
As for working out, not much was done yesterday. I was sore and my body was tired.
I had Banza Pasta for the first time since surgery. It's a chikpea based pasta, so no rice or corn is in it at all. It's a little high in carbs but they're complex carbs. I also tried Quest Protein chips for the first time ever. They were a little bland but were a nice change from my standard protein sources.
Food Journal:
Breakfast:
Vega all in one shake
Lunch:
Quest Protein Chips
Snack:
No sugar added Fudge pops
Dinner:
1 serving of Banza Pasta with a half cup of Wegmans Pasta sauce
Dessert:
A third of a pint of Halo Top ice cream
Saturday, July 15, 2017
February 13, 2017: Psych Eval
In the post about meeting the surgeon, I mentioned that psych evaluations were booking in May. After my first appointment with my PCP I was able to make my appointment for my psych evaluation, which was set for June 12. As with any appointment set for over four months in the future, I asked to be on the wait list.
On February 9, I got a call that said they could see me on February 13. Did I mention I have an awesome job for this procedure and all of the prep that goes into it? I was able to, without much notice, take the day off for the evaluation.
I went to the office for the appointment, and I was first met with a test on a computer. Then I went back for my evaulation.
It's not nearly as scary as it seems, especially as someone who had never sought the help of a mental health professional.
First she asked why I thought I was there, and I told her it was because I needed to prove that I understood I would not become skinny as a result of the surgery but rather with the assistance of the surgery.
We went through my medical past, which included a couple of items to focus on. One item was about six years ago, I dealt with a bad bout of Seasonal Affective Disorder. I sought the help of my PCP as I was sure it would not be a long term issue, and with some chemical help I got better. Since then, I have learned better coping mechanisms to deal with it.
Then we went through my test I had taken in the waiting room. She addressed that the only area I may have trouble with is self control, to which I was like "well there is an element of that with how I got here..."
Some issues the psychiatrist may go through are:
Anyway, I passed the evaluation with flying colors. One more check in the box on the way...
On February 9, I got a call that said they could see me on February 13. Did I mention I have an awesome job for this procedure and all of the prep that goes into it? I was able to, without much notice, take the day off for the evaluation.
I went to the office for the appointment, and I was first met with a test on a computer. Then I went back for my evaulation.
It's not nearly as scary as it seems, especially as someone who had never sought the help of a mental health professional.
First she asked why I thought I was there, and I told her it was because I needed to prove that I understood I would not become skinny as a result of the surgery but rather with the assistance of the surgery.
We went through my medical past, which included a couple of items to focus on. One item was about six years ago, I dealt with a bad bout of Seasonal Affective Disorder. I sought the help of my PCP as I was sure it would not be a long term issue, and with some chemical help I got better. Since then, I have learned better coping mechanisms to deal with it.
Then we went through my test I had taken in the waiting room. She addressed that the only area I may have trouble with is self control, to which I was like "well there is an element of that with how I got here..."
Some issues the psychiatrist may go through are:
- Eating disorders
- Addiction history
- Self control
- The presence of any mental disorders
- Confidence issues
Anyway, I passed the evaluation with flying colors. One more check in the box on the way...
January 30, 2017: Esophagogastroduodenoscopy
Yea, that's a long title.
As you may remember from when I met the surgeon, one of the items on my list was to get an esophagogastroduodenoscopy, or an EGD. I can't even say the long version of that...
This was not my first trip to the EGD rodeo. I had one in 2010 when trying to figure out why my digestive system hates me, and I got a colonoscopy done at the same time. Just before the anesthesia was started in 2010, I asked if they can take a picture of one camera with the other and they said they used the same camera, then I went to sleep. Without the colonoscopy prep, this procedure was going to be much easier.
I called the department to get the EGD done the same day as the surgical consult, and they got me in for the following Monday morning. This completely shocked me but I wasn't about to say anything.
In case you don't know what an EGD is and the whole idea of going to the hospital, being put into twilight, and having a procedure freaks you out, it's really nothing to worry about. If you want to read what the professionals have to say you can look here. This reads at a good eighth grade level, but here is what happened on that day.
First of all, you need someone to go with you, so I recruited my mom. From midnight the night before, I didn't eat or drink anything (though a small sip for medicine is usually ok, just check with the doctor). We took the drive to JH Bayview, and waited to be called back.
Once I was back in the prep area, things moved quickly enough. I was allowed to keep my undergarments on for this procedure as it is not done in a room with the clean standards of an operating room. After I was cleared by the pregnancy test (phew!) the nurse got an IV started.
As I hung out waiting, by this point mom was able to rejoin me, the doctor performing the scope stopped by to ask what brought me in for the test. I'm not sure if this is a Hopkins or all hospitals thing, but they like to hear in your own words why you are getting something done and what you are there for. Then the anesthesiologist came by to make sure she had all of the right information about my medical history.
Finally they rolled me back to the room. Once again, they did what is called a time out to ask me my name, date of birth, and what procedure I was getting done. They warned me about this by telling me this was normal and "they know what they're doing". They put a special mask on me to push oxygen while also leaving an opening to put the camera into my mouth, and the rest I don't remember.
I woke up to one of the assistant anesthesiologists asking me to cough. My oxygen numbers tend to dip a little bit and a little coughing got my numbers right up. The doctor came by to see mom while I was waking up, and then came to see me. The EGD showed a tiny polyp and low level GERD, which led him to ask if I was experiencing heartburn at all, which I was not. I got a copy of the report (with pictures!) and I was wheeled down and out of the hospital.
The recovery from the anesthesia was not bad. I felt like myself pretty early, and it was a chill half day off.
Flash forward about a month and a half. I followed up with a few questions I had to my surgeon, and she told me that the EGD showed her that I was no longer a candidate for the sleeve and I would need to have a roux-en-y gastric bypass if I wanted to proceed. I told her that was fine by me.
If you're reading this while on your journey, just know that if you're not sure what procedure to get, and you experience heartburn and/or have been diagnosed with GERD, your decision might be made for you.
January 26, 2017: First Visit with the PCP
As I mentioned in a previous post I needed to start my PCP (Primary Care Provider) appointments to really get underway with the pre-surgical process.
I never discussed surgery with my PCP, but she knew I was always trying to lose weight with minimal success. When I came in for that first appointment, there was a paper to write down goals and we worked on them together. She decided this first month would be low carb and I would start working out more regularly. We also discussed emotional goals, which for this first month would be to not take any candy off of any desks in my office. My guess is suddenly, candy lasted longer in the office.
I would also start measuring and tracking better. For this we got a good kitchen scale and began planning out all of our meals. I started to realize what I really needed to do to eat right on the run. About a week after this first appointment, I had a swim meet and I had to pack everything the night before and I had so much food to bring into the meet! I couldn't believe what it took to get ready and now, six months later, its become second nature for the most part.
Honestly these weigh-in posts with the PCP are going to be a bit boring. She would weigh me, and we would talk about nutrition, emotional, and physical well being. It was great to actually talk to my provider rather than be hustled through listening to lungs, pulse, and quickly discussing an issue. I feel like my PCP now really knows me and my needs as well as challenges I had to face and that's an amazing feeling. I'm not sure if I'll dedicate a full post to the next three monthly visits as they were fairly simple.
Next up: The EGD...
I never discussed surgery with my PCP, but she knew I was always trying to lose weight with minimal success. When I came in for that first appointment, there was a paper to write down goals and we worked on them together. She decided this first month would be low carb and I would start working out more regularly. We also discussed emotional goals, which for this first month would be to not take any candy off of any desks in my office. My guess is suddenly, candy lasted longer in the office.
I would also start measuring and tracking better. For this we got a good kitchen scale and began planning out all of our meals. I started to realize what I really needed to do to eat right on the run. About a week after this first appointment, I had a swim meet and I had to pack everything the night before and I had so much food to bring into the meet! I couldn't believe what it took to get ready and now, six months later, its become second nature for the most part.
Honestly these weigh-in posts with the PCP are going to be a bit boring. She would weigh me, and we would talk about nutrition, emotional, and physical well being. It was great to actually talk to my provider rather than be hustled through listening to lungs, pulse, and quickly discussing an issue. I feel like my PCP now really knows me and my needs as well as challenges I had to face and that's an amazing feeling. I'm not sure if I'll dedicate a full post to the next three monthly visits as they were fairly simple.
Next up: The EGD...
July 14, 2017: Six weeks and two days
Yesterday was one of those super slow days in the office. We have an hour for lunch and plenty of people go out for a long lunch on days that are slow, so why not go to the gym for a longer workout?
I went to Planet Fitness and utilized their PE@PF group for Legs and Abs.
Legs went something like this:
Single leg presses, 4x10 @ 40lbs
Single leg curls, 4x10 @ 40lbs
Single leg extensions, 4x10 @ 40lbs
After all of that we did 5 minutes on a treadmill at 15 incline (speed 1.8mph).
Abs came next. I had not done an ab workout since the surgery:
1 minute of Russian twists, two twists with a 6 lbs medicine ball, two twists no medicine ball. 30 seconds rest. Repeat 3 times.
Then the machines:
Upright crunch machine @ 40lbs for one minute. 30 seconds rest.
Bar press @ 50lbs for one minute. 30 seconds rest.
Recline crunch @ 20lbs for one minute. 30 seconds rest.
I repeated the machines because someone in the classes wanted to all of the floor stuff at once rather than get up and get back down. No problem.
After a second round on the machines, I went back to the floor. I went from an upright sitting position holding a medicine ball (6 lbs) over my head and laid back, sat up, and passed the ball to someone else, then did the same motion without the ball. Performed for one minute with a thirty second rest, and repeated three times.
Then came planks. The goal was two rounds of one minute planks and a thirty second rest. I made it about 30 seconds for each plank, and I was on my knees at that. But you gotta start somewhere.
Before I get into the food journal for the day, I had bought a small gluten free pizza from Dominoes, and I only had a quarter a day. I realized this was making my macros go nuts and gave my husband the last quarter of the pizza and I'm back on track starting tomorrow.
Food journal:
Breakfast:
Vega One Protein w/water
Mid morning snack:
Unsweetened Apple Sauce
Lunch (This was right after the gym so I was in serious need of protein. Eating this took about an hour):
Oikos Triple Zero
One egg salad
Afternoon snack:
No sugar added fudge pops
Dinner:
The infamous pizza
And because I needed more protein in my life:
An egg and a half.
Friday, July 14, 2017
July 13, 2017: Six weeks and one day
Yesterday was a hot day, but I did what I could to stay comfortable and get all of my steps and more in. I'm on soft foods for one more week.
Food log:
Breakfast:
Vega All in One Shake with Water
Mid morning snack:
4oz watermelon
Lunch:
Single egg salad
Afternoon snack:
Oikos Triple Zero Yogurt
Snack when I got home:
2 No sugar added Fudge pops
Dinner:
Quarter of a Dominoes Gluten Free Pizza
Single slice of cheese
Workout log:
11:30am: 30 minutes running on elliptical at work gym
6:40pm: 20 minutes of a 30 minute Planet Fitness circuit class, 30 minutes of PF360. PF360 consisted of the following (all were slated to do for a minute with 30 seconds between for rest):
Food log:
Breakfast:
Vega All in One Shake with Water
Mid morning snack:
4oz watermelon
Lunch:
Single egg salad
Afternoon snack:
Oikos Triple Zero Yogurt
Snack when I got home:
2 No sugar added Fudge pops
Dinner:
Quarter of a Dominoes Gluten Free Pizza
Single slice of cheese
Workout log:
11:30am: 30 minutes running on elliptical at work gym
6:40pm: 20 minutes of a 30 minute Planet Fitness circuit class, 30 minutes of PF360. PF360 consisted of the following (all were slated to do for a minute with 30 seconds between for rest):
- Torso twists holding a medicine ball and throwing it against the trampoline
- Plank
- Torso twists holding ropes
- TRX Suspension chest presses
- Bench dips
- Rope pulls from down low to chin @ 17.5lbs
- "Disco pulls" @7.5 lbs
January 23, 2017: Meet the Surgical Team
January 23, 2017 actually starts around October 12, 2016.
Johns Hopkins Center for Bariatric Surgery starts their process with a twelve page application to see if you are a good candidate for their surgery. A week after submission, an applicant can expect a phone call with an initial appointment. My initial appointment was set for January 2017. The online information session recommended I contact my insurance about their requirements to bring that along to the first appointment.
October to January was a weird time. I had not really told anyone I was thinking about the surgery, and I think I wasn't sold on it either. I decided I would go in with an open mind, and if I still hadn't decided I would at least start the process. Somewhere along the way I decided surgery was the way to go, which opened the floodgates for a bit of a three month long rumspringa.
The meeting with the team on January 23 set the tone for what I was about to go through. The Nurse Practitioner saw me first and painted the picture of the appointments to come, and even gave me the referrals for all of the needed appointments. Remember those appointments that I looked up from my insurance company? Yea, I sat there and compared, right there in the examination room, and everything lined up.
In order to have my paperwork submitted to insurance I had to do the following:
I left that meeting and got to business. I was told that Psych would be the most difficult to schedule so I literally called them from the parking lot, and they were right about that being difficult to schedule. Psych was scheduling for May, and again, this was January 23. Furthermore, they could not schedule me until after my initial appointment with my PCP or my appointment at Bayview. When I figured out this was going to take til the summer, I decided to save my gas and go to my PCP locally rather than drive to Baltimore monthly.
I got home and called my PCP and got in with her later that week, and I also was able to schedule an EGD on January 30 (some things do move fast in this process).
More importantly, I had to start thinking of myself as a Bariatric Patient.
One important thing I took away from the meeting was to start living the lifestyle change now. I was told this would contribute to future success and also if I did resistance training it would help to avoid "skin surgery" after I lost the weight. I want to avoid surgeries at any cost, so I started taking this very seriously.
This story can be taken a few ways. First of all, there are a lot of steps to go through, but this first step, meeting with a surgeon, can be as cheap as a specialist co pay. I felt confident that I could have walked in there, heard something I didn't like, and decided that surgery wasn't for me. But these initial days helped to solidify my decision, and I began to own it.
Next up: The PCP meetings...
Johns Hopkins Center for Bariatric Surgery starts their process with a twelve page application to see if you are a good candidate for their surgery. A week after submission, an applicant can expect a phone call with an initial appointment. My initial appointment was set for January 2017. The online information session recommended I contact my insurance about their requirements to bring that along to the first appointment.
October to January was a weird time. I had not really told anyone I was thinking about the surgery, and I think I wasn't sold on it either. I decided I would go in with an open mind, and if I still hadn't decided I would at least start the process. Somewhere along the way I decided surgery was the way to go, which opened the floodgates for a bit of a three month long rumspringa.
The meeting with the team on January 23 set the tone for what I was about to go through. The Nurse Practitioner saw me first and painted the picture of the appointments to come, and even gave me the referrals for all of the needed appointments. Remember those appointments that I looked up from my insurance company? Yea, I sat there and compared, right there in the examination room, and everything lined up.
In order to have my paperwork submitted to insurance I had to do the following:
- Four appointments with my Primary Care Provider known from here out as PCP (or three appointments at JH Bayview)
- An appointment with a Nutritionist
- An appointment with a Psychiatrist
- Attend a Group Support session
- Have an EGD done
- Have a sleep study done
I left that meeting and got to business. I was told that Psych would be the most difficult to schedule so I literally called them from the parking lot, and they were right about that being difficult to schedule. Psych was scheduling for May, and again, this was January 23. Furthermore, they could not schedule me until after my initial appointment with my PCP or my appointment at Bayview. When I figured out this was going to take til the summer, I decided to save my gas and go to my PCP locally rather than drive to Baltimore monthly.
I got home and called my PCP and got in with her later that week, and I also was able to schedule an EGD on January 30 (some things do move fast in this process).
More importantly, I had to start thinking of myself as a Bariatric Patient.
One important thing I took away from the meeting was to start living the lifestyle change now. I was told this would contribute to future success and also if I did resistance training it would help to avoid "skin surgery" after I lost the weight. I want to avoid surgeries at any cost, so I started taking this very seriously.
This story can be taken a few ways. First of all, there are a lot of steps to go through, but this first step, meeting with a surgeon, can be as cheap as a specialist co pay. I felt confident that I could have walked in there, heard something I didn't like, and decided that surgery wasn't for me. But these initial days helped to solidify my decision, and I began to own it.
Next up: The PCP meetings...
Thursday, July 13, 2017
Where All Good Things Start
I'm going to start where all good things start: with an introduction. Or maybe I should introduce myself through a series of poorly written statements, like a pilot of a television show would do.
I've always been big. Like, real big. And it never really bothered me. I kept up with people, did what they did, did more than what they did, and had a good health record all the while tipping the scales. I was a healthy fat person. I tried to lose weight, I really did. You name the diet and I probably did it. But, I would be successful, then not so much, and I'd be higher than where I started.
Suddenly I realized I was getting a little slower, and while attempting another crazy athletic venture I injured my knee and hip. This injury would literally wake me up in the middle of the night, because I rolled onto my left side. Then I realized something drastic had to happen.
My husband and I had been married for a year and we were talking about kids, but with both of us being bigger people, we both worried about fertility. Then, life opened up...
Was that too dramatic? I think I've led you on.
He got a new job with a temporary pay cut and would be higher in salary than he was in just a few years. So why would we stretch our dollar more than it would be by bringing a kid into the picture?
That's when Bariatric Surgery entered my vocabulary. And that's where my story starts. I'm going to leave it there because there is a lot to the story, and I'm trying to catch you up on the last seven months of my life while letting you know what I'm up to today.
So there's more.
There's a lot more.
But I'm going to keep you waiting. Here are some main points that may interest you:
I've always been big. Like, real big. And it never really bothered me. I kept up with people, did what they did, did more than what they did, and had a good health record all the while tipping the scales. I was a healthy fat person. I tried to lose weight, I really did. You name the diet and I probably did it. But, I would be successful, then not so much, and I'd be higher than where I started.
Suddenly I realized I was getting a little slower, and while attempting another crazy athletic venture I injured my knee and hip. This injury would literally wake me up in the middle of the night, because I rolled onto my left side. Then I realized something drastic had to happen.
My husband and I had been married for a year and we were talking about kids, but with both of us being bigger people, we both worried about fertility. Then, life opened up...
Was that too dramatic? I think I've led you on.
He got a new job with a temporary pay cut and would be higher in salary than he was in just a few years. So why would we stretch our dollar more than it would be by bringing a kid into the picture?
That's when Bariatric Surgery entered my vocabulary. And that's where my story starts. I'm going to leave it there because there is a lot to the story, and I'm trying to catch you up on the last seven months of my life while letting you know what I'm up to today.
So there's more.
There's a lot more.
But I'm going to keep you waiting. Here are some main points that may interest you:
- I live in Maryland and had my surgery at Johns Hopkins
- For reasons I will get into later I had a Roux-En-Y Gastric Bypass
- I had my surgery on May 31
- My story of January to May 2017
- Tips on food
- Tips on exercise
- Crocheting, gaming, and other crap that just jumps into my brain
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