1 year after gastric bypass...what I've learned (so far)

One year ago, yesterday, I had a gastric bypass.  I started out at 353 lbs, and a size 30/32.  I couldn't walk with out major lower back pain--to the point that getting from my car to my house might as well have been a marathon.  I didn't travel because I couldn't fit into the airline seats (if I didn't collapse from pain just trying to GET to the plane).  I could (and did) eat a whole pizza in an evening.  I knew that I did not have a diet left in me, and I knew that I was dying a whole lot quicker than a 36-year old should be.

What a difference a year makes.

I'm down 155 lbs., to about 198 (194 according to my Wii, and 202 according to my scale, so I'm splitting the difference).  I wear a size 18.  I don't have lower back pain, and I don't even think about how far I have to walk (except when it's really cold, raining, or snowing) to get to my front door.  I fit in an airline seat and I can even lower the tray table.  I don't eat pizza (tomato sauce tastes funny to me now).  I work out now, and my life expectancy is much closer to normal.

It's like getting a second chance.

Now, I don't recommend this path for everyone.  While I've reaped a lot of benefits so far, I am concerned about what this will look like in another 5 or 10 years.  I've seen a lot of post-ops regain a lot of the weight they lost (factoring in the 10% regain that is normal).  I've heard of a lot of people who have permanent problems, from severe nutritional deficiencies to major issues getting sick on everyday food.  I know visits to the doctor or ER will always create problems for me, and that I have to watch those treating me like a hawk so that they don't accidentally give me ibuprofen or sugar popsicles.

But I'm one of the lucky ones, so far. 

Last night, I went out with a group of friends to celebrate.  We went to dinner, then for fro-yo, and then back to my house for a Wii dance-party.  I can't remember the last time I had so much fun, or felt so much joy for just being.  I'd forgotten how much I love being around people, doing things, and just participating in my own life.  See how happy I look (I'm in the middle)!

I updated my photo in the left side, as well.  It's a picture of me standing in the same spot as 1 year before.  Now you can actually see the door frame behind me!  As I was editing the blog page to add the photo, I noticed in my self description that if I were to be in a sitcom, I would be "The Wacky Neighbor."  Still true (I am a bit wacky and tend to make an entrance by falling into the room), but now I'm starting to feel a little like the Leading Lady.  Maybe by this time next year, I'll manage to transition to being the Star of my own show.

Stay tuned to this channel to see it evolve...

Gastric Bypass "surgiversary" is almost here.

Yup.  This Friday will be one year since I had the Roux-en-Y gastric bypass at Rose Medical Center with Dr. Michael Snyder.

It's an exciting date, but one filled with mixed emotions.  Excitement, anxiety, happiness, sadness--you name it, I've got it.

My goal was to reach the 100's mark (known in the bariatric community as "one-derland") by the one-year mark.  According to my Wii Fit scale, I'm in the right area, fluctuating between 198 and 202. According to my other scale I haven't, saying I'm fluctuating between 202 and 206.  My other scale can suck my big toe. Either way, I think I'm in the right place, even if it's not quite exact.

The hitch in my giddyup to congratulate myself, however, is all because I made the mistake of reading an article that stated bariatric patients will have lost 80% of their excess weight within the first year.  According to my doctor, I was about 200 lbs in excess of my ideal weight.  80% of that (hey, math!) is 160 lbs.  160.  Not the 150-and-change that I've lost.    It shouldn't be such a big deal right?  I'm close, right? 

Here's the thing.  I started out as a rock-star, losing almost 100 pounds in the first 4-5 months after surgery.  I was a weight-losing wunderkind.  Then things started to slow down, considerably.  It's taken me 7-8 months to lose the next 50 pounds, so I'm no longer at rock-star status.  To go from rock-star to not-even-quite average is hitting me hard. 

I guess the light at the end of the obsession tunnel is that it is a good reality check for me.  I've started to recognize that I've let myself wander off the path of what I'm supposed to be doing far too often.  I eat sugar occasionally.  I let myself have carbs.  I choose the protein bar that tastes better (which for protein bars meas that they taste less ass-like) instead of the protein bar with the least carbs/sugar and highest protein.   I often justify it with "I want to have a life and not let the weight loss prevent me from having things I love."  Which is good when it's once a week because it keeps me balanced and lets me enjoy life.  More than once a week, though, and it truly is the old fat me just trying to justify having whatever I want, whenever I want it.  The fact that I'm not losing at a decent pace is a sign that I'm living in "Babe-land" instead of reality again.

So here's the thing.  I have to remind myself that I have limitations--ones I chose to put upon myself so I can lose weight and live a real life.  I have to remind myself that the old food-addict is still there, ready to come out, and that I'm not done with making changes to my brain.  That the next year is going to be harder, but that this past year has helped me train for the struggles ahead. 

In thinking all of this through today, it made me realize that I need to mark this occasion with a congratulations for what I HAVE acheived (even if it's not perfect).  I particularly want to make it a day of gratitude for what I have, that I was given the chance to make these changes, and for the people in my life who have been so supportive (and who I will probably need over the next year to continue to support me).  So decided to have a little party in my own honor--nothing big except a dinner out (to somewhere with a delicious buffalo-style grilled chicken breast that I've been obsessed with lately), a sugar-free dessert (that I'm making), and some fun activities (bowling, karaoke, or Wii Dance Party--the decision is still up in the air).  

Of course there are lots of people long-distance I would love to include--all my readers here included--but instead I will just send and post pictures here.  Consider yourselves on the inside, because just having regular followers and reading your comments has been a major source of support for me.  Thank you all!

Post #100!

That's right, peeps.  It's my 100th post.  Weird, right?  Anyone who knows me knows that I am not a "stick-to-it" kind of girl.  I'm more of an idea gal, and it's best if someone else does all the details and followup.

But it's been a year and a half, and I have 100 posts to show for it.  When I started, it was May of 2009.  I was still trying to do Weight Watchers and hadn't even gone to the seminar on bariatric surgery.  I knew change was imminent, but I didn't know how or why.  I was miserable, and couldn't walk from my house to my car without having to stop and rest at the bottom of my stairs.  I had full-blown sleep apnea, and weighed 353 pounds (give or take a few).  I wore a size 30/32 shirt--on my thinnest days (I don't even know my pants size because I just kept wearing my 26/28 until they stretched to fit).

In November 2009, I went to the bariatric seminar given by my surgeon to educate people on surgical options and to help them decide if it's right for them.  It's been a year since I decided to have the surgery, and so far I'm so glad I did (recap alert!):
1.  I survived 2 major surgeries, 2 strictures, 3 ER visits, 9 days and 8 crazy nights in the hospital, all with my good humor intact (mostly).
2.  I can walk to and from my car without even thinking.  Hell, I went hiking on a mountain, cardio-kickboxed, pilates-ed, elliptical-ized and can even go up and down stairs.
3.  I am 5 pounds shy of having lost the equivalent weight of my entire mother.  Soaking wet and wearing shoes.
4.  I had to give away my "skinny" clothes because they were too big, and I shopped and actually bought clothes in a store that sells regular sizes.
5.  My surgeon didn't recognize me until I told him that I was "the one with the NG tube who you told was going back into surgery if I had gone one more day with a swollen-shut pouch." (he remembered that!)
6.  I have spent more on my medical condition this year to date than I made in a year at my first HR job.  And if you include all the expenses of weird, high-protein food, vitamins, new clothes, pilates classes, gym memberships, and special "hair-loss" shampoos, I've spent more this year to date than I made when as a regional HR manager.

It's a hell of a lot to pack into 100 measly little posts.  But here is what I'm hoping in the next 100:
1.  Buy all my clothes at a store that is not exclusive to plus sizes.
2.  Lose 34 more pounds, which will make me "overweight" instead of obese.  If I really want to shoot for the moon, I'll lose 64 pounds, which would put me at "normal."  That is absolutely unimaginable to me.
3.  Try more fun exercise stuff--Zumba, Hot or Core Power Yoga, ride a bike--outside, Boot camp (well, maybe not that one, that doesn't sound like fun).
4.  Look into and possibly start the process of surgical skin removal and a tummy tuck.
5.  Sit in an airline seat WITH the tray table in it's non-upright position (and not resting on my belly, either).
6.  Ride a roller coaster.  Or not.  But just to at least have the option.
7.  Date.  Someone.  Anyone.  Preferably a dude (nothing against the ladies!).
8.  Be able to travel.
9.  Ride a horse.  Or a cowboy (see #7).  Whatever.
10.  Wear an inappropriately sexy Halloween costume.  Maybe just in the dressing room, but still!
 Probably a whole lot more stuff that I can't even think of right now.  But the possibilities are out there!

Just to close this one out, I thought I'd leave you with a little glimpse of what I see now when I look down.  It still surprises me (especially that I fit into these cute new tights!), and I'm wondering when I'll stop being amazed that this is me...

I'm a star! And a role model! (be very afraid...)

This Thursday night,my surgeon held a bariatric seminar, which he requires all of his pre-op patients to attend.  He talks about his background (Dr. Michael Snyder of Rose Medical in Denver, also the inventor of the Full Bars you may have seen on late-night TV), the different surgical options, and what each one entails.  I was invited to be one of the speakers on the panel of post-ops, who tell their story and answer questions.

This was really exciting, because:
1.  They thought of me as a post-op success story (so far...)
b.  They realized how articulate and charming I am
3.  It's a great way to remind myself of where I was, and where I am now

It was a wonderful experience.  I got to see my surgeon while standing vertically, instead of lying down and drugged up.  I wish I'd had a chance to talk to him, but he got a call into the ER and had to leave early.  I would have liked to see if he still recognizes me, or if remembers that it's me whose new pouch was swollen shut for 7 days (and that he told me if it went one more day that he would have taken me back to surgery--which he's never had to do).

The biggest thing is remembering what it was like for me to attend the very same seminar, back in November of 2009.  I remember that I was worried about how far I would have to walk before I could sit down, because I was in so much pain.  I remember being too timid to ask any questions, or talk to any of the post-op panel.  I remember trying hard not to cry as I listened to him speak, and as he reignited the hope that I could have a life again.

So that's what I told everyone on Thursday.  I brought my before picture, and heard someone ask, "Which one is that?" because they weren't sure who on the panel the pictures belonged to.  I introduced myself, told them what kind of surgery I had, when I had it, and how much I've lost (down 130 now, which is only 15 pounds shy of what my mother weighs).  I told them the best thing about the surgery was getting my life back--being able to do things, go out, walk as much as I want, and all without pain.  I told them that the worst thing is the routine and planning--I'm not naturally good at either and have to work on it every day. 

What I didn't tell them was that I've only lost 5 pounds in the last month, and am worried about how I might not lose more.  Or that I will gain it all back again.  Or that I still cannot control myself around bread, but sweets now hold very little appeal to me.  I didn't tell them that I used to order pizza 2-3 times per week, and that I haven't had real pizza since the last night I was allowed to eat before surgery.  I didn't tell them about the strange comments I get while losing weight, or that I get mad when I get judgmental looks for being fat (I assume) and that I really want to shout, "You think I'm fat NOW?  You should have seen me in January!"  I also didn't share that I'm so anxious to get to a size 16 or less, so that I can shop at normal-sized clothing stores (I'm still around a size 22, since all my weight is in my midsection).  And what if I never get there?

And I don't know if it was right of me to leave that part out.  Because I wanted to know that sort of stuff as a pre-op.  I just didn't know how to ask anymore than I knew how to say it this time around.  Such a long way I've come, and yet such a long way to go...

An off day, and a shout-out to the Melting Mama!

Today hasn't been the best day.  I dropped my enormous cup of SportTea before even making it to my car, and I have a hard time drinking plain water or even Crystal Light sometimes.  I didn't get in all my protein today, and I went out with a friend and ate queso--that was my dinner.  Not the best choice.  I'm sure I'll pay for it sometime around 3am.

My fear when I have a day like this is that I'll stop doing all the stuff that keeps me healthy and dropping weight, and then I'll gain it all back and/or get really sick.  So days like this mess with my mind as much as they do my body.  Tomorrow is a new day.  I'll pre-pack a great bunch of protein and try to eat more regularly and drink as much as possible.

These fears are not new to me.  I've worried about weight gain since before I even had the surgery.  I did the math and figured if I could lose 70% of my excess weight and then gain back a mere 10% (which I'm told is nearly inevitable, I'm still over 100lbs lighter that I was when I started.  But like any right-brained person, I can see the math, and know it adds up, and yet still not FEEL like it's true.

These thoughts really came to a head when I checked out my blog roll.  You must go read Melting Mama, who I admire the heck out of.  She just had the Facebook version of being a drive-by victim (with words instead of bullets--just as powerful, but less likely to show on an airport x-ray).  People accusing her of not "doing it right" because she has gained some of her weight back.  (By the way, she is still down a LOT of weight, and she has new medical issues that make things much harder, and she is honest about how weight loss surgery has both benefitted and detracted from her life.  I see her as a success story--a success at life, which is much more than getting to and staying a size 6).  Seeing someone as funny and brave and wonderful get brow-beaten by people who are still judging others by size and not by life experience made me really mad.  And then sad.  And then mad again.

So rather than rehash the whole thing and let more negativity out into the world, I'd just like to say to my sister, Melting Mama, that the Babe has your back.
Peace and love, my sister.

I'm back, b*tches!

I hope that title doesn't offend anyone.  It just gives me the triumphant attitude-filled title I was looking for.  Probably the fact that I'm apologizing for it just neutralized any of that fabulous attitude I had worked up, but hey, that's the magic that is me.

Here's the update.  On the day of my 3-month surgiversary for gastric bypass, I went back in for another abdominal surgery--an umbilical hernia repair.  Back when my bariatric surgeon told me he found a hernia and stitched it up "while he was in there," I was thrilled that I was getting away with two surgeries for the price of one.  But folks, there ain't no such thing as a free lunch.  Umbilical hernias have a nasty habit of needing extra reinforcement, being one of the body's natural weak spots, and stitches (especially impromptu stitches) don't usually hold up.  So I had another 2-hour surgery, 6 new scalpel marks on my belly, 8 days off from work, a mesh panel implant in my belly, an overnight hospital stay, and a partridge in a pear tree.

Despite all this, I am extremely lucky.  I got in for the surgery just in time, since my bowel had started to work its way out of my abdominal cavity (which can be really serious if it isn't caught).  I was able to schedule the surgery in advance so that I could make plans to be off work.  I have a job working for amazing people who are understanding, and I have FMLA protection to boot.  My parents were already planning to visit me the same week I went in for the surgery, so I had support and assistance from my family.  And, luckiest of all, I already knew how to be my own health care advocate. 

I've said it before--when it comes to your health YOU must be the one to stand up for yourself.  You cannot depend on the government, your insurance company, your doctors or nurses, or your family to do it for you.  I was reminded of this time after time while in the hospital this go-round.  Some highlights:
*I remembered to tell the anesthesiologist that I woke up from my last surgery unable to feel or use my feet (and that I still have some residual neuropathy in my toes).  She was then able to figure out a way to pad my lower back during surgery so that there was no unnecessary nerves getting pinched.
*I had to fight with them on the pain meds they gave me.  And I mean fight.  I had so much bruising and pain because of all the issues and they wanted to give me Advil when I went home.  I insisted on getting the same meds that the bariatric doc gave me post-surgery, and thank goodness for it.
*They had no idea how to feed me.  I told the nurse "act like I'm diabetic" first, and then realized she was putting in my chart that I had diabetes.  I told her to change it and put down that I was on a "no sugar added diet".  Even so, twice I had to question people who came into my room to get my blood sugar.  They had seen "no sugar" on my chart and assumed I was diabetic.  Luckily I caught them before I was force fed juice or given any insulin.
*I had to practically beg to get a bag of saline pushed into my IV to help give me a hydration boost before I left.  I explained that I dehydrate very easily now, and that I can't always drink enough to keep from getting constipated.  And trust me, constipation when you've just had your 2nd abdominal surgery for the year is a fate up there with "please just kill me now."
*No one came by to get me out of bed to walk around.  As I learned from my last surgery, you need to get up and move to help prevent blood clots and to get your circulation going.  Good circulation = faster healing, yet I had to keep reminding them that I wanted to move around on a regular basis.

So yeah, you can't just lay back and expect them to know everything you need to get and stay well.  You have to speak up.  It's best to do it politely so that you are just a person who wants to heal and not "the pain-in-the-ass in room 810"  (although I've probably also been that person once or twice).  But learning to advocate for myself is a huge step.  Not only will it help me get the care I need, but it reminds me that I am WORTH getting that kind of care.  Those of us with serious weight issues need to constantly reaffirm that we deserve good healthcare, and that we have the right to speak up in order to get it.

I also just want to say to all of you, thank you, everyone, for hanging in there with me.  Every time someone joins my list, reads my blog, or posts a comment I am reminded that life is worth not just living, but also worth sharing.  And I like to think that if my random ramblings make you laugh, or make you think differently about something, or inspire you, or reinforce your confidence in being your own advocate, that my struggles are worth it.

And the diagnosis is...

Belly Butt is trying to burst free!  (I just like the alliteration). 

I was very excited that I was getting 2 surgeries for the price of one:  gastric bypass and an umbilical hernia repair (I didn't even know I had a hernia until the surgeon said that he would fix it "while he was in there").   Well, the repair didn't take, and so my pain issues have all been traced back to the hernia, uh, re-heriating (?). 

So, like the story of my life, it's good news/bad news.  Good news:  Pouchie is fine and there is no infection.  Bad news:  the Belly Butt will need another surgery to fix it.  Could be worse, right?  It's a simple out-patient surgery and I should be home by evening, with just a couple days off work, thank goodness.

But I did have a fun trip to the ER last night to get the CAT scan (which, strangely enough, my own cat was not able to perform for me).  The admission nurse ended up being a friend of mine, so it was nice to see a familiar face.  He also gave me good advice..."build up your muscles to be successful with your surgery."  However, it looks like weight lifting will be on hold for a little while.  So my admission went well, the scan went well, and then there was the waiting.  And the multiple teams of Doogie Housers that stopped by on occasion to prod at my belly and nod their heads at one another.  Seriously, I think I have underwear that is older than these people (TMI?).

Finally the grown-up surgeon came and told me it was an umbilical hernia, but that I wasn't in danger and that I could go home as long as I followed up the next day to schedule surgery.  Hot damn!  She said that they would do my discharge paperwork and bring it in in a few minutes.  So I patiently waited.  Um, sort of.

(Now is a good time to explain that I am a polite, rule-following kind of girl.  If they tell me to wait behind the line, I will wait behind the line.  I might be right up on it, or let a toe cross, but I will stay behind the line.  That is, except when I haven't eaten in 24 hours.  Then I am a raving bitch, apparently.)

An hour later, I realize that I'm very thirsty, hungry, and still in a little pain.  In short, the recipe for disaster.  I finally went up, opened the door to my room and told the first person who passed wearing scrubs, "Either you take this damn IV out, or I will.  My surgeon released me, I haven't eaten in 24 hours, and I'm going home--with or without paperwork."  (I kinda kick ass, right?)  Her eyes went really wide and she told me that the surgeon hadn't released me in their computer and that she didn't know.  I might have responded with something like, "Well, now you do," and she scampered off to get the required stuff.  I went back in my little room for another 20 minutes and then figured, screw it, what are they going to do?  Call the principal?  Tell me I'm a bad patient?  Report me to my mother (OK, that one I'm a little worried about, but the others sounded ridiculous.).

So I pulled out my own IV, dropped it in one of those ugly little kidney-shaped dishes, got dressed, grabbed my shit, and opened the door.  I found the first doctor and told him I was leaving now.  Lo and behold, the paperwork materialized in front of my eyes and I signed my name and took off for home.  8 hours after getting there.

Now I know they were just doing their job, and that a little hernia is on the bottom of the priority list, but I was pretty proud of myself for standing up and taking care of business.  I don't know that I would have done that before losing weight, but I'm finding that I am the only one who has a truly vested interested in my wellness.  Nurses and doctors do their jobs, and god bless them for it, but if it all goes wrong they go home at the end of the day knowing that they do the best they can.  I'm the one who goes home with a new hernia, peripheral neuropathy, or perhaps doesn't go home at all.

And God help them if they have to call my mother on me.

Boy, is my stomach stubborn!

That's right, it leaps small staples in a single bound!  It dances away from the surgeon's blade!  It laughs in the face of an upper GI!  It spews whatever nutritional entity is introduced to it!  It is...Pouchie the Pain-in-the-a**!

That's right, my surgery was not the smoothest.  Apparently my liver is the size of a football and I have a hernia in my belly button that needed repair (I had thought I was getting so fat that my belly button was caving under pressure).  So the surgery itself was difficult.  Then, when I woke up, I couldn't feel my feet.  I couldn't stand, walk, stroll, wiggle my toes...nothing.  Finally, the new stomach pouch (which I have christened "Pouchie") was taken in to the upper GI test, where he would not surrender the bariatric dye.  That's right a blockage.

To keep it from getting too graphic (as my friend D. will lose her cookies), I was in the hospital for 8 days instead of 2.5.  Yikes.

But I can tell you that I can already stand, and walk, and bend at the waist (a little, anyway).  I do have to have supplemental oxygen, but they think that as my body loses fat that my lungs will get the extra room and I will be fine.

Let's see how the weekend goes...