Just as a little bit of background before I jump into it, my husband's family with little exception all lives in a town in Southeast Texas. We've gotten out there about once a year since we started dating because we can see so much family in a single shot. Also, his grandmother (Meemaw from this point forward) had Lou Gehrig's Disease. She passed away on September 6, 2017.
If you have put a few pieces of this puzzle together, she passed away during a time of a natural disaster (Hurricane Harvey), and partially due to this the services had to take place nearly two weeks after she passed away.
When we got the sad news, we assumed things would happen quickly and the price of last-minute flights made it cost-prohibitive for both of us to go. A day later, we found out the service would be in about ten days, and we managed to find cheap airfare so both of us could go. After all, if Meemaw knew you, you were her grandchild and she loved you as such.
So today's story hits on two things, dealing with a high-stress situation, and traveling.
This was not my first post-operative trip, we went to Canada when I was eight weeks out. But, when we went to Canada, I was not cleared to eat all foods yet, so I found myself reverting to be safe as I didn't want to have an emergency so far from home.
At nearly 16 weeks out, I can eat practically anything, so the thought of what to eat for safety was no longer present which made some things easier, but also presented a danger for eating the wrong things.
I'm not going to sit here and write that I made every perfect decision and I would proudly present my food journal to my nutritionist or surgeon. The facts remain that I wrote everything down, and I did the best I could. A few key points made this possible:
1) I have a supportive husband who is willing to share plates. I'm going to start a new series of entries about my husband going through his own WLS journey (he starts in a few weeks from writing). So he understands where I'm coming from, and also that portions at restaurants are so huge, me having my three or four bites does not take anything away from his experience. Especially since the surgery, we haven't eaten out all that much. We would discuss what to order, then when it came to the table I had a small plate for my own serving. I know some hospitals give out cards to keep in your wallet that you have a medical necessity to order from the kid's menu. After this weekend, I am solid in my choice to not even ask for that card. The choices on the kids menu are generally less healthy than the main menu. They are there as usual kid crowd pleasers.
2) Planning planning planning. I have said in past posts that failing to plan is planning to fail. From the start of planning out our flights and our day of travel (we were landing at 3:30pm, getting lunch with my in-laws, who were on the same flight, and driving the 90 minutes to the destination) we planned out how we were going to get what we needed for a good trip. Before we even got on the plane, we made a list of things we would need at Walmart when we landed. This list included pre-made Premier Protein (a luxury to us), Cheerios, water flavoring, and fiber laxative. We stopped at Walmart and made our purchases, which carried us through the trip.
3) Think "protein" first. Every time I put something in my mouth, I thought "protein" first. I tried to keep my normal day for as long as possible every day, and no matter how the day ended, I restarted with the normal day the next morning. My normal day is my fiber laxative, protein shake, and a little later Cheerios (dry). At that point my days change as I mix up lunch and dinner. While the family was eating the food local organizations had so generously brought, I had my lunchbox. On the way in, I bought beef jerky from Buc-ee's. For non-Texas people, Buc-ee's is just a magical rest stop with the cleanest bathrooms you'll ever experience, along with fun food options. What caught my eye was the beef jerky bar, and we bought enough jerky to share with everyone. Also, beef jerky takes so long to chew, especially post-op that it would really keep me busy.
This wasn't the happiest of trips either. It was the first time I found myself in a situation where I would have eaten a lot from stress eating before the surgery. I was a little nervous going into it, but honestly I had no desire to overeat. I wonder how this will change in the future, but I had no issue saying no, and more importantly, no family pushing anything on me. This was the first time everyone had seen me since I lost any weight, so I was down 90 pounds since the last time I saw them.
This trip proved a lot to me about what I'm capable of and what level of planning it takes. The most important part is that as long as I am able, a Walmart should be my first stop, even before I get to a hotel. Research and preparation will allow anyone to have a successful trip.
Showing posts with label gastric sleeve. Show all posts
Showing posts with label gastric sleeve. Show all posts
Friday, September 22, 2017
Tuesday, September 12, 2017
My Own Decision
Some of the most common things I see on the various Facebook support groups I follow include what brands of vitamins to take to save money, and what finally made people decide that surgical weight loss was the way to go.
If you've ready my story, you know how I arrived here. For those of you that didn't read it, my size was defining physical limitations that were becoming more limiting by the day, so it was time to do something about it.
I thought about surgery from the start of physical therapy for a knee and hip injury in July 2016 and applied through Johns Hopkins in October 2016. I was still not convinced when I applied, but since that twelve-page application deemed me eligible, I decided it was something to really consider. Still, however, I told myself not to make up my mind until I saw the surgeon. Even after the appointment with the surgeon, I made the first couple of appointments, which were an EGD and my first appointment with my Primary Care Provider, I still wasn't convinced. Either way though I was going to lose a little weight. I don't know exactly when my mind was made up, but by the second month of my process, I knew that surgery was the right choice for me.
To oversimplify my thought process, I'm going to break this up into Pros and Cons.
Pros:
1. I will lose weight quickly: This one speaks for itself. No other program boasts up to a 75% excess weight loss in 18 months.
2. I am more likely to keep it off: Of course everyone I talk to has a cousin that has a friend that had the surgery and then gained it all back and then some. But, the numbers tell me that more people have greater long term success due to surgery. This surgery is altering how my body absorbs food, so as long as I'm not actively seeking out all of the loop holes, I will be successful.
3. All of the other pros of weight loss: More energy, less over all pain, better fertility. All the things that other programs can offer as well as weight loss surgery.
Cons:
1. Surgery is scary: Someone is knocking you out to the point where you can't even breathe on your own and rerouting your body. Yes, its scary. But I was deemed medically necessary by the surgical team as well as my insurance, so this must be a risk worth taking.
Counterpoint: My first surgery was when I was 28 years old. It was a tonsillectomy and I needed it. Like, my tonsils touched when I swallowed and were terribly infected so my quality of life was not too good. I was scared, but I knew I had to do it, otherwise every few months I would be sick for a week at a time, and each time I got sick, it got worse. Finally one day I realized that I'm one bad turn of the steering wheel or even one bad step, away from needing emergency surgery where I would have the time to go through my own existential crisis. That actually soothed me.
2. There are no guarantees it will work: Yes the surgery makes your stomach a lot smaller, but I can just change my eating habits and get it all in. There are ways for this to fail and the surgeon and your team are not with you all day helping with your choices. One side effect of the long pre-op is you have plenty of time to think and decide if this is really right for you.
3. Possible complications: Every surgery carries risk and unfortunately these risks are multiplied for those who are overweight/obese.
Counterpoint: See con 1. You never know when you need surgery. Also, if you follow the instructions to the letter, you decrease the chance of complications significantly.
If you've ready my story, you know how I arrived here. For those of you that didn't read it, my size was defining physical limitations that were becoming more limiting by the day, so it was time to do something about it.
I thought about surgery from the start of physical therapy for a knee and hip injury in July 2016 and applied through Johns Hopkins in October 2016. I was still not convinced when I applied, but since that twelve-page application deemed me eligible, I decided it was something to really consider. Still, however, I told myself not to make up my mind until I saw the surgeon. Even after the appointment with the surgeon, I made the first couple of appointments, which were an EGD and my first appointment with my Primary Care Provider, I still wasn't convinced. Either way though I was going to lose a little weight. I don't know exactly when my mind was made up, but by the second month of my process, I knew that surgery was the right choice for me.
To oversimplify my thought process, I'm going to break this up into Pros and Cons.
Pros:
1. I will lose weight quickly: This one speaks for itself. No other program boasts up to a 75% excess weight loss in 18 months.
2. I am more likely to keep it off: Of course everyone I talk to has a cousin that has a friend that had the surgery and then gained it all back and then some. But, the numbers tell me that more people have greater long term success due to surgery. This surgery is altering how my body absorbs food, so as long as I'm not actively seeking out all of the loop holes, I will be successful.
3. All of the other pros of weight loss: More energy, less over all pain, better fertility. All the things that other programs can offer as well as weight loss surgery.
Cons:
1. Surgery is scary: Someone is knocking you out to the point where you can't even breathe on your own and rerouting your body. Yes, its scary. But I was deemed medically necessary by the surgical team as well as my insurance, so this must be a risk worth taking.
Counterpoint: My first surgery was when I was 28 years old. It was a tonsillectomy and I needed it. Like, my tonsils touched when I swallowed and were terribly infected so my quality of life was not too good. I was scared, but I knew I had to do it, otherwise every few months I would be sick for a week at a time, and each time I got sick, it got worse. Finally one day I realized that I'm one bad turn of the steering wheel or even one bad step, away from needing emergency surgery where I would have the time to go through my own existential crisis. That actually soothed me.
2. There are no guarantees it will work: Yes the surgery makes your stomach a lot smaller, but I can just change my eating habits and get it all in. There are ways for this to fail and the surgeon and your team are not with you all day helping with your choices. One side effect of the long pre-op is you have plenty of time to think and decide if this is really right for you.
3. Possible complications: Every surgery carries risk and unfortunately these risks are multiplied for those who are overweight/obese.
Counterpoint: See con 1. You never know when you need surgery. Also, if you follow the instructions to the letter, you decrease the chance of complications significantly.
Tuesday, September 5, 2017
Presurgical Shopping List
I remember getting ready for my surgery and thinking to myself how different life was going to be as soon as I got home from the hospital. I was nervous, excited, anxious...so many emotions at once.
I was well prepared, the program at Johns Hopkins had gotten me ready and I was more excited than anything to get the petal to the metal. Hopkins even makes their guidelines available to the public, if anyone would like to read over the material.
The weekend before the surgery, I went shopping and got two sets of the below list. I got two because I was going to be spending nights at my house, but would be spending most days at my parents' apartment since my mom works from home and is an RN. This list was derived from the guidelines linked above:
The biggest key however is getting at least that 64 ounces of water in daily. Before discharge I got a water bottle from the hospital that had increments of 2 hours to get 8 ounces of water in. If I started at 7:00am, and I was consistent, I would get my 64 ounces in by 11:00pm. I still use the one from Hopkins, but I found inspiration here. But, even taking a standard 32oz Nalgene with a Sharpie would work, but you would have to remark it fairly regularly.
Finally, I made a paper chart with goals based on the timeline in the guidelines attachment. I would include all of my new vitamins and medications on this list as well. I don't have any copies of these left, but it looked something like this:
I was well prepared, the program at Johns Hopkins had gotten me ready and I was more excited than anything to get the petal to the metal. Hopkins even makes their guidelines available to the public, if anyone would like to read over the material.
The weekend before the surgery, I went shopping and got two sets of the below list. I got two because I was going to be spending nights at my house, but would be spending most days at my parents' apartment since my mom works from home and is an RN. This list was derived from the guidelines linked above:
- Protein powder
- Lowest fat cottage cheese
- Plain Greek Yogurt
- Dannon Triple Zero Oikos
- No sugar added pudding pops
- Sugar free popsicles
- Fairlife skim milk
- Ricotta Cheese (lowest fat)
- Pudding (powder)
- Jell-O
The biggest key however is getting at least that 64 ounces of water in daily. Before discharge I got a water bottle from the hospital that had increments of 2 hours to get 8 ounces of water in. If I started at 7:00am, and I was consistent, I would get my 64 ounces in by 11:00pm. I still use the one from Hopkins, but I found inspiration here. But, even taking a standard 32oz Nalgene with a Sharpie would work, but you would have to remark it fairly regularly.
Finally, I made a paper chart with goals based on the timeline in the guidelines attachment. I would include all of my new vitamins and medications on this list as well. I don't have any copies of these left, but it looked something like this:
- 7:00am: Protein Shake made with Fairlife and AM pills
- 8:00am: Water
- 9:00am: Greek Yogurt (make sure water goal is met), Lovenox shot
- 10:00am: Water
- 11:00am: Fudgepop (make sure water goal is met)
- 12:00n: Protein shake made with Fairlife and Noon pills
Tuesday, August 22, 2017
Living on a budget (vitamins and protein)
It is no secret that eating healthy
is more expensive than not eating healthy.
I can go to Little Caesar's and get
a medium pizza that will feed both my husband and myself for $5.99 or go next
door to Panera and spend over $6 for each of us to get a salad. All of this is
situational seeing as I'm gluten free by medical necessity.
I'm not going to go over this fact
again as many blogs and sites have done it themselves.
But Bariatric surgery has an added
level of complication. Post-op, patients need to buy protein supplements and
vitamins. These can add up to astronomical levels. Some say that the money
you're saving on food can help balance the budget, but I haven't completely
found that to be true as I am still feeding my husband.
Let's start with saving money on
protein:
Addressing once again that I'm one
of the cheapest people I know, I will remove a little satisfaction from my food
to save significant money. That is exactly what I do with Pure Protein. I have
had better brands with better flavors, but Pure Protein is $17.98 for 29
servings. That means I go through one of these every four weeks.
Going on to vitamins:
I decided to use Celebrate vitamins
when I started this process simply to take less vitamins any given day. But,
does this add up to savings at the register? I'm going to compare two options
at prices for every thirty days. All vitamin intake must meet these minimum
standards.
- Daily intake of 65mg Iron
- Daily intake of 1500mg Calcium Citrate
- Daily intake of 800mg Folic Acid
- Daily intake of 3mg Thimine
- Daily intake of 2mg copper
- Daily intake of 3000IU Vitamin D3
- Daily intake of 500mg B12
- Preferably has selenium and zinc
- Oh, and chewable only for the first 6 months
- AND you can’t take gummy vitamins
One option that many seem to take is
to take Flintstones Vitamins and then supplement what else they might need. Looking at
our list, if you use the iron minimum to decide how many vitamins to take, you
must take six Flintstones a day (and this is with enhanced iron). At six
Flintstones a day, you meet the requirements for Iron, Folic Acid, and Thimine.
This means you are still missing Calcium Citrate, Copper, Vitamin D3, Vitamin
B12.
Some quick math on walmart.com
showed me that:
- Best value for Flintstones was $27 for 180 pills (or $27 for 30 days)
- Best values for Calcium Citrate (includes part of daily supply for D3) was $15 for 155 pills (or $12 for 30 days)
- Best value for Copper was $7 for 300 days (or $1 for 30 days)
- Even with the Calcium Citrate in this scenario, you still need one D3 which was $13 for 240 pills (or less that $0.50 for 30 days)
- Best value for B12 sublingual $4 for 200 days (or $1 for 30 days)
- Total vitamins daily: 12 (6 Flintstones, 1 Copper, 1 D3, 1 B12, 3 Calcium)
Flintstones come to about $41.50/30
days to meet all requirements.
At first, I thought it was going to
be more expensive to buy the special brand name bariatric vitamins for my
needs. Due to the values of the needed minerals and vitamins, there is no need
for extra supplemental items to buy. Let’s see how they measure up:
- Multivitamin chewable (without Iron) is $42 for a 90 day supply ($14 for 30 days)
- Iron supplement (chewable): The price discrepancy is significant depending on how much you need. I’m on the high end as I had gastric bypass and I still have my period. The cost range is $21.50-$35 for 90 days (or $7.17-$11.67 for 30 days)
- Calcium is interesting because this vendor offered soft chews, which taste better and have a better texture, but in my (cheap) opinion is not worth the extra price. The cost comes to $45 for 90 days ($15 for 30 days)
- Total vitamins daily: 6 (2 MV, 1 Iron, 3 Calcium)
Going with Celebrate Brand means
less work organizing your vitamins weekly. This is something I spend about 10
minutes a week doing to get me set up for a full 7 days.
Celebrate Brand vitamins would cost
$36.17-$40.67/30 days. This means that a patient would save a little less than
a dollar to go the Celebrate route.
Wednesday, August 9, 2017
When Food gets Stuck
It happened again on Monday night.
My husband makes this dish called "Poor Man's Meal" which is basically cut up potatoes, cut up hot dogs, some tomato sauce, and cheese. Not the most nutritionally sound thing in the world, but he could make a lot worse.
So, I was under my calorie goal for the day and above my protein, so when I came home from my knitting and crocheting group, I figured I would have a little bit of my husband's creation.
As I put the first bite in my mouth, I started talking to him, and swallowed before I was done chewing properly.
Before anything happened, I knew I did something wrong.
The advice to chew for 20 seconds (or 30 times, whatever your nutritionist tells you) is not only to slow you down, but to have your food better prepared to go into your stomach. First of all, I'm only 10 weeks out so my stomach is pretty much still recovering. Second, the point where the stomach passes food into my small intestines is the size of the tip of my pinky finger. Normal people's stomach to small intestine passageway is the size of a quarter.
When I saw my nutritionist for the first time, she didn't say this might happen, but that it would happen. I was told to not drink, because that wouldn't help "de-clog". Drinking would only make the situation worse (I had to learn for myself).
And that's the point of what happened on Monday.
I wasn't careful in chewing and swallowed without thinking and completing my chewing. Immediately I knew simply not puking would be a gold star for the evening. I quickly put the remainder of my bowl away, and went upstairs to start my night time routine. I felt better after my shower, but I knew I couldn't drink or even take my last vitamins for the day.
Sometimes I have to throw up to feel better after a clog. On Monday night, I stayed vertical a little longer than usual and I was able to fall asleep without vomiting. I did however skip my vitamins which would not be recommended.
The moral of the story is that chewing is important. I find myself trying to make meal time about meal time and not about talking to someone else which does not make me the best for dinner company. That adds into my attempts at not socializing around food.
Which is another entry for another day...
My husband makes this dish called "Poor Man's Meal" which is basically cut up potatoes, cut up hot dogs, some tomato sauce, and cheese. Not the most nutritionally sound thing in the world, but he could make a lot worse.
So, I was under my calorie goal for the day and above my protein, so when I came home from my knitting and crocheting group, I figured I would have a little bit of my husband's creation.
As I put the first bite in my mouth, I started talking to him, and swallowed before I was done chewing properly.
Before anything happened, I knew I did something wrong.
The advice to chew for 20 seconds (or 30 times, whatever your nutritionist tells you) is not only to slow you down, but to have your food better prepared to go into your stomach. First of all, I'm only 10 weeks out so my stomach is pretty much still recovering. Second, the point where the stomach passes food into my small intestines is the size of the tip of my pinky finger. Normal people's stomach to small intestine passageway is the size of a quarter.
When I saw my nutritionist for the first time, she didn't say this might happen, but that it would happen. I was told to not drink, because that wouldn't help "de-clog". Drinking would only make the situation worse (I had to learn for myself).
And that's the point of what happened on Monday.
I wasn't careful in chewing and swallowed without thinking and completing my chewing. Immediately I knew simply not puking would be a gold star for the evening. I quickly put the remainder of my bowl away, and went upstairs to start my night time routine. I felt better after my shower, but I knew I couldn't drink or even take my last vitamins for the day.
Sometimes I have to throw up to feel better after a clog. On Monday night, I stayed vertical a little longer than usual and I was able to fall asleep without vomiting. I did however skip my vitamins which would not be recommended.
The moral of the story is that chewing is important. I find myself trying to make meal time about meal time and not about talking to someone else which does not make me the best for dinner company. That adds into my attempts at not socializing around food.
Which is another entry for another day...
Monday, August 7, 2017
Stigma, Judgement, Myths, and Misconceptions
I'm going to start with this fact: I applied for my weight loss surgery in October of 2016 and I was not too open about my application. I would like to think that I wasn't open about it because I honestly had not made a decision, and wanted this decision to be mine and mine alone. I told my family, but I did not tell my husband's extended family so when one of them came for a visit in the spring and I was well into preparations, it took her by surprise. After all, I had not mentioned anything over Christmas.
As the process continued, I was open with people I spoke to and saw every day. But there was an audience that was in the dark about this decision: my extended army of Facebook friends. Now, I personally know all of my Facebook friends, and I occasionally go through and delete people that I don't see myself getting back in touch with. I had a tentative surgery date of June 14, so I decided I would tell the greater Facebook community on April 14, two months to the day when I was to go under the knife.
The support I got was amazing and I wondered what took me so long to tell more people what I was going through.
Before becoming a bariatric patient myself, I always wondered why people would decide to make the decision to have weight loss surgery. As I developed my own reasons for the surgery, I gained a new respect for friends that had taken this path before I did. I never thought as surgery as an easy way out, I just thought it was extreme.
The other night I came across this article written about a woman who has had bariatric surgery and denies it when people ask her how she lost weight. The stigma that surrounds weight loss surgery patients is deep and complicated. Bianca mentions an article, published in the peer-reviewed medical journal Obesity Surgery. In the study, individuals are shown before and after pictures of individuals who had lost weight and rated them based on their opinions of the pictures (Vartaniam and Fardouly, 2013). Then, the individuals are told which ones had weight loss surgery. The opinions of the individuals in the study towards individuals who has the surgery dropped dramatically. Further more, the individuals who had weight loss surgery were seen as "significantly more lazy and sloppy, less competent and sociable, less attractive, and having less healthy eating habits" as compared to those who lost weight using more traditional methods having less harsh descriptions.
I had a hard time wrapping my head around this idea that people are judging me negatively based on this decision I had made. After all, I'm still watching what I eat and going to the gym. Only rarely does my stomach dictate how much can go in, I usually stop eating well before that pressure reminding me that my stomach is the size of an egg begins.
Ultimately, the overwhelming opinion is that everyone will lose weight if you eat less and move more. Most bariatric patients will tell you that is not the case. There are nutritional considerations to make, and types of exercise to consider. The solution is not a one-size-fits-all situation.
I have surprised many with the depth my journey took me before having my surgery even scheduled. The design of the Johns Hopkins program is to get you ready for surgery by starting to develop good habits beforehand. Like most stereotypes, if someone took the time to get to know someone going through it, many misunderstandings will go away. Which is a big reason why I started this blog. If you have the time to want to understand the process, I'm hoping this blog can help.
I'm going to end this with two stories of resistance I've met in the last year:
During my pre-op diet, I found great success. But, I knew I usually lose between 40-60lbs and then maintain it for about six months before gaining it back. Several people asked me why I would get the surgery when clearly I'm able to do it on my own, and I would explain to them that I've never been able to keep it off. One person went so far as to treat me as if I were in hysterics and told me "we are going to do this together, without surgery". The message I had to tell her was that I don't think her less for not wanting the surgery, but this is a decision I have made because the time is right and it's time for a change.
The second story is from December, right after I had applied and I hadn't told anybody outside of my immediate family. My husband's family is mostly in Texas and I had strongly considered not telling them and surprising them with our next visit. When we were at one of the houses on our circuit, my husband's uncle came up to him and commented (note that his verbal filter has been eroded by years of substance abuse) "not getting any smaller, why don't you get that gastric bypass?" My husband was so mad just knowing the process, not living it as he would within two months' time.
To overcome the overwhelming feeling of stigma, attending in-person support groups as well as online ones can help a lot. There are so many people involved in those groups, when I look at my newsfeed these days, I wonder how many people on my newsfeed have not had weight loss surgery.
Like all choices in life, we are judged. I don't judge people who don't get the surgery because insurance and time off can make that tough. I just hope that my decision to get the surgery warrants the same respect.
As the process continued, I was open with people I spoke to and saw every day. But there was an audience that was in the dark about this decision: my extended army of Facebook friends. Now, I personally know all of my Facebook friends, and I occasionally go through and delete people that I don't see myself getting back in touch with. I had a tentative surgery date of June 14, so I decided I would tell the greater Facebook community on April 14, two months to the day when I was to go under the knife.
The support I got was amazing and I wondered what took me so long to tell more people what I was going through.
Before becoming a bariatric patient myself, I always wondered why people would decide to make the decision to have weight loss surgery. As I developed my own reasons for the surgery, I gained a new respect for friends that had taken this path before I did. I never thought as surgery as an easy way out, I just thought it was extreme.
The other night I came across this article written about a woman who has had bariatric surgery and denies it when people ask her how she lost weight. The stigma that surrounds weight loss surgery patients is deep and complicated. Bianca mentions an article, published in the peer-reviewed medical journal Obesity Surgery. In the study, individuals are shown before and after pictures of individuals who had lost weight and rated them based on their opinions of the pictures (Vartaniam and Fardouly, 2013). Then, the individuals are told which ones had weight loss surgery. The opinions of the individuals in the study towards individuals who has the surgery dropped dramatically. Further more, the individuals who had weight loss surgery were seen as "significantly more lazy and sloppy, less competent and sociable, less attractive, and having less healthy eating habits" as compared to those who lost weight using more traditional methods having less harsh descriptions.
I had a hard time wrapping my head around this idea that people are judging me negatively based on this decision I had made. After all, I'm still watching what I eat and going to the gym. Only rarely does my stomach dictate how much can go in, I usually stop eating well before that pressure reminding me that my stomach is the size of an egg begins.
Ultimately, the overwhelming opinion is that everyone will lose weight if you eat less and move more. Most bariatric patients will tell you that is not the case. There are nutritional considerations to make, and types of exercise to consider. The solution is not a one-size-fits-all situation.
I have surprised many with the depth my journey took me before having my surgery even scheduled. The design of the Johns Hopkins program is to get you ready for surgery by starting to develop good habits beforehand. Like most stereotypes, if someone took the time to get to know someone going through it, many misunderstandings will go away. Which is a big reason why I started this blog. If you have the time to want to understand the process, I'm hoping this blog can help.
I'm going to end this with two stories of resistance I've met in the last year:
During my pre-op diet, I found great success. But, I knew I usually lose between 40-60lbs and then maintain it for about six months before gaining it back. Several people asked me why I would get the surgery when clearly I'm able to do it on my own, and I would explain to them that I've never been able to keep it off. One person went so far as to treat me as if I were in hysterics and told me "we are going to do this together, without surgery". The message I had to tell her was that I don't think her less for not wanting the surgery, but this is a decision I have made because the time is right and it's time for a change.
The second story is from December, right after I had applied and I hadn't told anybody outside of my immediate family. My husband's family is mostly in Texas and I had strongly considered not telling them and surprising them with our next visit. When we were at one of the houses on our circuit, my husband's uncle came up to him and commented (note that his verbal filter has been eroded by years of substance abuse) "not getting any smaller, why don't you get that gastric bypass?" My husband was so mad just knowing the process, not living it as he would within two months' time.
To overcome the overwhelming feeling of stigma, attending in-person support groups as well as online ones can help a lot. There are so many people involved in those groups, when I look at my newsfeed these days, I wonder how many people on my newsfeed have not had weight loss surgery.
Like all choices in life, we are judged. I don't judge people who don't get the surgery because insurance and time off can make that tough. I just hope that my decision to get the surgery warrants the same respect.
Wednesday, August 2, 2017
August 1, 2017: Eight weeks, six days
Today was back to the office, but only for three days. Not a terribly eventful day. I had a project that really tied me to my desk, so I didn't get to tell stories about our vacation to my coworkers. But I did catch up on my podcasts.
I had a lunchtime workout followed by my "meal planning" of another slice of leftover pizza.
One thing about sitting all day for 8 hours was I found the need for a standing desk to be much stronger than it had been in the past. I spoke to some people in my office to see about getting the ball rolling and plan to write a message to my surgical team agreeing with my need for a standing desk. I also got the blessing to put an IKEA standing desk hack on my desk for the time being! Yay projects!
Food journal:
Breakfast:
Protein shake
Mid morning:
Banana
Lunch:
Slice of pizza
Leftover beet salad (like a quarter cup...two months ago I would have thrown that out but now...different story!)
Afternoon snack:
Oikos Triple Zero
After workout snack:
Slice of Cheese
Dinner:
18 medium grade shrimp
Cocktail sauce
Workout Journal:
Lunchtime:
3 miles in 30 minutes
After work:
Chest:
Pec Fly 4x12 @40
Assisted Dips 1x10 @175, 2x8 @ 160 (lower the weight the more body weight you're pushing)
That badass move where you're between the cables and using two machines making a hulk motion 3x12 @ 15 each arm
PF360
Chest pull with upright cable
Russian Twists with 6lb ball
Shoulder pulls
Box Jumps (level 2)
Rope shuffle
TPX Squats (w/jump first time w/o jumps second)
Kettle Bell alternates with 15lbs
I had a lunchtime workout followed by my "meal planning" of another slice of leftover pizza.
One thing about sitting all day for 8 hours was I found the need for a standing desk to be much stronger than it had been in the past. I spoke to some people in my office to see about getting the ball rolling and plan to write a message to my surgical team agreeing with my need for a standing desk. I also got the blessing to put an IKEA standing desk hack on my desk for the time being! Yay projects!
Food journal:
Breakfast:
Protein shake
Mid morning:
Banana
Lunch:
Slice of pizza
Leftover beet salad (like a quarter cup...two months ago I would have thrown that out but now...different story!)
Afternoon snack:
Oikos Triple Zero
After workout snack:
Slice of Cheese
Dinner:
18 medium grade shrimp
Cocktail sauce
Workout Journal:
Lunchtime:
3 miles in 30 minutes
After work:
Chest:
Pec Fly 4x12 @40
Assisted Dips 1x10 @175, 2x8 @ 160 (lower the weight the more body weight you're pushing)
That badass move where you're between the cables and using two machines making a hulk motion 3x12 @ 15 each arm
PF360
Chest pull with upright cable
Russian Twists with 6lb ball
Shoulder pulls
Box Jumps (level 2)
Rope shuffle
TPX Squats (w/jump first time w/o jumps second)
Kettle Bell alternates with 15lbs
Tuesday, August 1, 2017
July 31, 2017: Eight weeks, 5 days
Today was the first day back at work since our road trip. Getting back into routine is always a little tough so I mixed up the routine a bit.
First, I went to the Army Wellness Center, as civilians are allowed to do, and got my Body Fat Percentage through a very accurate tool called a Bod Pod. The only comparisons were from about 15 months ago, and 34 pounds lighter than my actual high weight. Still though, I dropped 4% body fat as well as 9 lbs of muscle. Obviously we want to see the body fat drop more than the muscle.
During lunch I did the 30 minute PF circuit and it worked out well.
After work I walked with my friend while she walked her dog then we went out for dinner. I had two bites of a beet salad along with a single slice of gluten free pizza.
Food journal:
Breakfast:
Protein Shake
Morning snack:
Banana
Lunch:
Swiss cheese (2 slices)
1 serving of Halo Top
Dinner:
A couple of bites of a beet salad
A single slice of pizza
Workout journal:
30 minute circuit class during lunch
Mile or so walk after work
First, I went to the Army Wellness Center, as civilians are allowed to do, and got my Body Fat Percentage through a very accurate tool called a Bod Pod. The only comparisons were from about 15 months ago, and 34 pounds lighter than my actual high weight. Still though, I dropped 4% body fat as well as 9 lbs of muscle. Obviously we want to see the body fat drop more than the muscle.
During lunch I did the 30 minute PF circuit and it worked out well.
After work I walked with my friend while she walked her dog then we went out for dinner. I had two bites of a beet salad along with a single slice of gluten free pizza.
Food journal:
Breakfast:
Protein Shake
Morning snack:
Banana
Lunch:
Swiss cheese (2 slices)
1 serving of Halo Top
Dinner:
A couple of bites of a beet salad
A single slice of pizza
Workout journal:
30 minute circuit class during lunch
Mile or so walk after work
Monday, July 31, 2017
Abdominal Binder
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!
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!
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
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.
Friday, July 21, 2017
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
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)
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