"Though we travel the world over to find the beautiful, we must carry it with us or we find it not."
-Ralph Waldo Emerson

Saturday, January 30, 2016

Trigger Foods

One of my mom’s concerns about me having this surgery is that I told her that I was going to try to forever stay away from certain kinds of foods.  I told her that I hoped one day I could eat them without having issues, but that I needed to be prepared to avoid them if they became trigger foods.

So what is a trigger food?  A trigger food is a food that makes you want to eat more; it’s any food that you have trouble resisting and leads you to overeating.  Different people have different triggers.  I knew that breads are my downfall--I LOVE bread.  I actually feel pretty confident that I can turn down cake, but bread is altogether different!

I have found that my ideas of trigger foods have changed over time.  I have managed to stay away from bread products for the most part.  I do have a couple of crackers occasionally.  I have been able to turn down cake several times now.

I think my trigger food, unfortunately, is popcorn.  I used to absolutely love SmartFood White Cheddar Popcorn.  I allowed myself to buy a small bag of it over the Christmas holidays, figuring I would limit myself to about ¼ cup of popcorn per day as a snack.  Well let me just say that it went down so easy and tasted so good!  I did not experience any restriction… I could have eaten the whole bag in one sitting.  I read somewhere that they call popcorn and chips “slider foods” because they just slide right through and you can just keep eating.  So obviously after eating almost a cup of popcorn in one sitting, I realized that popcorn was a big danger to me.  Sure--a cup of popcorn isn’t too bad.  My problem is I kept wanting more.  I wanted to eat the whole bag and then buy more.  So I threw away the rest of the bag.  And I haven’t bought any since.

I would like to think that I can eat anything in moderation--and in my ideal world, I can.  But I also understand that I’m flawed when it comes to food.  I just need to be aware of my difficulties.  And it’s okay for me to mess up or make a less healthy choice.  I just don’t want those less healthy choices to become the norm or a common thing in my life.  I’ve lost so much weight and it’s more important to me that I live a healthy lifestyle.  My health and weight loss are more important to me than the transient pleasure of popcorn.

Thursday, January 28, 2016

5 Months Post-Op

I'm five months post-op and I thought I'd share what eating and health look for me at this time.

I feel pretty damn good to be honest.  I've lost a total of about 73 lbs so far.  I eat about 800-900 calories per day--a lot of protein and veggies with some fruit too.  I do have a little bit of healthy carbs thrown in the mix now, like I had a little tiny bit of cornbread crumbled over my chili tonight.  Sometimes I will have a cracker or two with something like a stew.  I usually eat 4 small meals per day--probably about 3/4 cup of food in a sitting.

I really enjoy eating healthy at this point.  That's not to say that I never make choices that are on the less healthy side--my son wanted Five Guys last weekend and it was my first burger in over five months.  I had about half of a little bacon cheeseburger with veggies and I took off the bun.  It was pretty yummy but I don't feel tempted to run out and eat all the burgers.  I also had some ice cream this week for the first time and I felt horribly ill afterwards.  I won't be eating ice cream again for a long time.

I drink a lot of water.  I have to really focus on my water goals because it's hard to fit in all the water when I'm busy and can only drink a little at a time.  I can't down a whole water bottle at one time.  I have to take a few swallows and then wait a few minutes.  So I definitely have to watch the time and be aware of how much water I'm taking in.

I didn't really begin my exercise routine until the New Year.  I was recovering from my complications and then I started work again right after Thanksgiving.  I was pretty exhausted and my surgeon told me to wait until after the holidays.  So I began on Monday, January 4.  I walk every morning before work and I take the weekends off.  I started with 30 minutes per day and bumped that up to 45 minutes on Fridays.  This week I am walking 45 minutes per day with the intention of walking an hour on Friday.

I also started physical therapy for my knees.  I had knee realignment surgery on each knee several years ago and I never built my strength back up.  I wanted to make sure that I take good care of my knees because I never want to have surgery again.  So I need to take good care of my body.  I do about 15 minutes of therapy at home every day and then go in for an hour of PT one or two times per week.  I'm hoping to build up to 30 minutes at home every day, but at the moment I'm happy to get in my 15 minutes.

On top of my physical health, I've been working on self-exploration and affirmation.  I have blogged about it in the past, but I have found journaling to be very helpful.  I start with an affirmation and then list five things I'm thankful for.  I draw an oracle card to meditate or journal on and then I just jot down my random thoughts.  Gratitude is my word for 2016 and I will be reaching out and thanking people around me.  I will be more aware of all the wonderful people and experiences in my life.

One thing that could be better in my life is that my weight loss has totally stalled.  I haven't lost any weight (or gained any weight) since the beginning of December.  It kind of sucks, but I've been pretty patient with it.  I know people stall at different points after bariatric surgery.  Plus, I know I must have lost some muscle mass with all my complications.  I am most likely losing fat but also gaining muscle.  But it's still pretty frustrating.  For now, I'm going to keep doing what I'm doing and see what happens over the next couple of weeks.

So that's a pretty good summary of myself at five months post-op.  I have my six month post-op appointment coming up in the middle of February (even though I'll only be about 5 1/2 months post-op).  I will try to post some before and after pics soon.

Wednesday, January 27, 2016

My Surgery and Recovery Story

My Surgery and Recovery Story

I wanted to share my story with others because my recovery involved complications.  First I want to say that bariatric surgery--of any kind--is NOT the easy way out.  It is a difficult road, and you still have to do all the work.  Yes, it is an invaluable tool for weightloss.  The surgery gives you time to set up good, healthy eating habits.  It causes restriction on the amount of food you can eat, helping you control your portions.  You get full very easily.  You lose weight fairly quickly at the beginning, which gives you encouragement and belief in yourself that you can do this.  I cannot even begin to tell you how amazing this tool is.  But it is not easy.  I still struggle with the desire for food--for that quick fix for everything.  Food was my coping mechanism, my way of feeling whole and satisfied in every way possible.  I can no longer turn to food for that fulfillment.  I have to turn down types of foods that I really enjoy because I know they are not a healthy choice for me, or because I know I will have trouble controlling my eating.

With that said, let me tell you my story…

I had researched bariatric surgery for 2-3 years before my surgery date.  I even did Ideal Protein for a number of months as my kind of last chance with diets.  I had to save up my own money for the surgery since my insurance specifically excludes bariatric surgery.  I read books, articles (scientific and personal), and read through blogs and forums for information.  I did my homework.  I attended information sessions at the hospital and at the surgeon’s office.  I know two other women in my circle of acquaintances who have had the vertical sleeve.  I asked questions and put together an information binder for myself.  I saved and I planned.

Once I had the funds I made my consultation appointment with my chosen surgeon.  Let me point out here that I researched my surgeon too.  I chose one who was well-known and respected.  I chose him because he was a Surgeon of Excellence with the Bariatric Board, and also because his office offered BLIS insurance for self-pay patients.  I should also point out that if you’re self-pay, the process is a lot faster.  I could have had my surgery within a few weeks of that initial consult, but I chose to wait until after our family vacation last July.

I had no issues with anything leading up to the surgery.  I had all my appointments and tests and there were no issues.  I also didn’t have too much difficulty with my two-week pre-op diet.  It lacked variety, which kind of sucked, but I was also excited about the surgery so I was able to get past it.  I told only my closest family and my boss about the surgery.  I only told one friend in advance because I knew she wouldn’t judge me.  I didn’t tell any of my co-workers.  I was trying to avoid any negativity going into the surgery.  I did intend to be absolutely honest about my weight loss once people started asking questions.  I planned to tell people about the surgery--I’m not ashamed of it.  It’s a personal decision and I absolutely understand why some people choose to be a little less than honest about how they lost weight.

So I had my vertical sleeve gastrectomy on August 31, 2015.  The surgery went fine with no initial complications.  I stayed overnight in the hospital.  Yes, there was pain that first night.  It was not fun to get up out of the bed to pee or go for a walk.  But I eventually managed to do both.  I was released the next day and went home to recover.  I think everything for me was pretty normal that first week.  I tried to walk a little every day--even if it was just around the house or up and down the driveway.

Monday, September 7, was Labor Day Holiday, but I did return to work the following day on Tuesday, September 8--only one week after I went home from the hospital.  I took it easy those four days and I was super tired.  The recommendation for recovery is 2-4 weeks, but I have a tendency to return to work early.  I didn’t want to use up all my leave and I figured if I didn’t feel well then my boss might allow me to work a little from home.  I always worry about taking advantage.  I did okay that week too.  I didn’t really notice any problems.  I was pretty exhausted, but that’s to be expected with so little calories and a liquid only diet.

That weekend I started feeling kind of bad.  I felt really tired and I had a bit of a stomach ache.  I returned to work on Monday and just felt kind of blah.  Tuesday I called in sick.  When I was getting ready for work that morning I had felt a horrible muscle cramping near my stomach--I almost fainted from the pain and panic.  I told my boss that I think maybe I had overdone it.  My husband had to drop something off at work for me and he spoke to my boss about my being worried about missing any more work.  My boss commanded that I take off the rest of the week to recover.  Have I mentioned that I have a fabulous boss?  I also called my surgeon because by that point I was not getting in all my fluids.  I would feel overfull from just a sip and I felt yucky.  My surgeon suggested that it was probably just a cramp from where they stitch the muscle from the surgery, but he also suggested that I could go to the ER to have it checked out just in case.  The ER he recommended was a hospital about an hour from where I live because he is a surgeon there plus they accept the BLIS insurance.  He didn’t seem terribly concerned and I held off.  I figured that I had just overdone it and just needed some rest.  Plus I wasn’t sure how I could get there.  My husband and I share a car and he had to work that week.  So I just waited.

By Friday there was no improvement and my surgeon called me back to see if I was any better.  When I told him no, he highly recommended that I go to the ER that day--preferably before noon so he could look in on me.  I started feeling a little concerned, but at the same time I didn’t want to inconvenience anyone.  My husband was at work and wouldn’t be home until early evening.  My mom was working and although she’s flexible I knew she had planned to leave work early that day to drive out of town to babysit my niece and nephew.  When I talked to my mom, though, she expressed worry and offered to take me.  At first I turned her down, thinking I would wait until she got home on Saturday or Sunday.  Then I gave myself a quick kick to the pants and called my mom back.  I knew that I wasn’t feeling well and was probably dehydrated.  It would be a bad idea to wait a couple more days.

It was early afternoon when we arrived at the ER.  They took blood and sent me for a CT scan.  I waited a long time for the results--I think it took a few hours.  Then they told me they would be admitting me--the CT scan showed an abscess near my stomach.  The abscess was about the size of a softball.  No wonder I didn’t feel well!
The following six days were really pretty terrible.  I will try to remember the details of my complications as best I can, but so much happened.

They decided that they would do a CT-guided drain rather than open me up and do one surgically.  The thought was that with the CT, radiology could thread the drain tube in precisely where the abscess was.  Let me just say that this was excruciating.  Although there was some pain management for the procedure, I could feel everything and it was horrible.  I remember moaning and crying out in pain during the whole thing.  It was horrible--probably the worst experience of the whole situation and up there with my two or three top worst experiences in my life (and I’ve been through a lot of pain in my life!).  I could also hear the radiologist say something about what was coming out being brown.  All I could think in that moment of pain was that maybe they pierced my bowels.  I remember that something smelled off, but I was very out of it--I was totally wrapped in my pain at the time.  Well, they didn’t pierce my bowels.  The abscess was a hematoma--infected blood.  So that explains the dark color and the bad smell.  They drained what they could at the time and left in a drain for the rest.

When they wheeled me back into my room afterwards, I remember I could hear the voices of my family, but I just kept my eyes closed.  I couldn’t deal with them or with anything.  I moaned with pain.  I was in a lot of pain for a number of days following the drain.  During that hospital stay, one of my blood cultures came back positive for staph, so then they had to redo the cultures and I was put on some crazy antibiotics.  I was just miserable.  I didn’t sleep well.  I was in constant pain.  The pain meds didn’t last more than an hour or two.  They had to switch my i.v. because my vein started collapsing.  It was horrible.  I was miserable and I just wanted to go home.  I was told that with the staph I would need a central line and I’d have to be on i.v. antibiotics for 2-4 more weeks at home.  Well it turns out that the first culture was wrong--I didn’t have staph!  Yay!  I stayed in the hospital for six nights and was sent home.  I was told that I should feel better in a few days.

A few days later I was not feeling better.  I still felt horrible and really wasn’t having much to drink.  When my symptoms hadn’t really improved, my surgeon sent me back to the hospital for a CT scan with contrast.  I will pause here to express my dislike and fear of needles--especially i.v.’s.  I’m irrationally terrified of needles and my previous hospital stay had not helped my fear.  So I was freaked out a little about the contrast.  They went ahead and did an i.v. for it.  The scan came back that the abscess had returned :(  So the surgeon on-call came in and performed outpatient surgery on me that same evening to put in a drain laparoscopically.  I was disappointed and upset that they had to go back in and that I was still so far from being recovered, but at least I wasn’t being readmitted!  And I will say that although it sucks to have surgery of any kind, this was waaaaaaaaaaaaaaaaaaaaaay preferable to the CT-guided drain.  

I went home and was told to expect to feel better in a few days.  Once again I wasn’t recovering like I was supposed to.  Six days after the drain was put in, I saw my surgeon for a check-up and he was concerned.  He didn’t like the color or the amount of stuff draining.  Plus, I still wasn’t getting in the fluids that I needed and I still wasn’t feeling well.  They had me wait at my surgeon’s office while the hospital prepared a bed for me to be admitted.  I was in tears and horribly upset.  I had had such a bad experience during my last stay, and I just didn’t seem to be getting better.  I was admitted to the hospital.  This time the CT scan showed that not only did I still have fluid draining, but now I had a small stomach leak.  When you have a stomach leak after bariatric surgery, they can’t just go in and stitch it up--your new stomach won’t hold stitches well.  So instead they decided they would put a stent in my stomach to stop the leak and to protect the stomach while it healed.  In the meantime, a nurse showed up at my room to pick me up for a central line.  I totally freaked out!  I’ve mentioned my absolute fear of needles and this was a much crazier i.v.--in my neck!  I was terrified and I had a total meltdown.  They backed off immediately.  It seems that they thought I had been informed about the procedure when I had not.  I calmed down and even spoke to my sister-in-law (an ob/gyn) who explained what a central line was and why it would be beneficial for me.  Not only could they “feed” me proteins and fats, but it would mean that they could draw blood without my regular i.v.!  That means no more collapsing veins!  So I calmed down and told them I was willing.  They still held off another day--I think I scared them with my freak out.

That stay was the longer stay.  They put in the stent and I was on the central line.  Let me say now that the central line was awesome.  My pain meds would go through so fast!  I would be asleep before they even finished putting the meds in the central line.  Plus they were able to give me vitamins, fats and proteins so I was finally getting some nutrition!  I think my only problem at that point was that I felt pretty nauseous from the stent.  By the end of the stay they also had to remove the central line (which was a little scary too).  My veins would burn when they’d give me pain meds.  So by the time I left the hospital, I was ready to go home.  I honestly don’t remember how long I stayed at the hospital that time.  I think it was about 10 days, but it may have been more like 12 when I look at the calendar.

I finally had my final CT scan a couple of weeks later and it came back clear!  It was such a relief!  Once the drain was out, I started feeling better and could finally start eating.  I stayed home another couple of weeks and then returned to work.

It was an interesting and difficult journey.  I did not expect complications when I went into this surgery.  I just assumed I’d make it through okay.  And I was lucky that I did okay considering the complications I had.  That original abscess could easily have killed me.  I feel incredibly lucky.  I am also very thankful for everyone who supported me during the whole damn thing.  I have even made “Gratitude” my word going into 2016.  I have written lots of thank you notes and created gratitude gifts for everyone who stood by me.  I think that I have put so much of myself into becoming healthy in part due to the horrible experiences I went through.  It’s even more important to me that I not waste this opportunity to be healthy.

I will write again soon about my weight loss and what I’ve been doing.