Sunday, December 29, 2013

Sleeping and body image

My mother went home after spending four days at my house.  It's nice to have my place to myself again, although I do miss her.  I know that she will be living with me in the future, probably after she retires from her job, so these little visits over are good.  She's alone and, especially as she gets older, I don't want her living by herself.  I really am more amazed each day at hour our relationship just continues to grow and flourish, especially after such an abusive childhood.  This helps me see that really all things are possible.

It looks like my APAP machine (CPAP with auto adjustment features) is in so I'm going tomorrow to get a fitting.  I told the person on the phone that the mask I was given to do the sleep study just isn't working for me and that I'd like to have the nasal pillow.  It was pretty amazing in how easy that conversation went because they told me it wouldn't be a problem.  I'm so grateful to have insurance because the machine along with everything associated is completely free to me.

My biggest problem with sleep is that the only position I can sleep in is on my tummy.  That's normally fine, but that is not going to work after I get the gastric bypass surgery done.  What happens to me is that I'll lay on my back and I'll start to fall asleep, but then I either snore or stop breathing and then I wake up.  I've tried many different positions to make it happen - bigger pillows, smaller pillows, sitting up, laying perfectly flat.  No matter what I do, I just can't get to sleep.  This is a big reason I decided to get on the machine for the sleep apnea so early when my surgery won't be for another eight months or so ... I need the time to adjust.  My dad said he has the same problem but he was able to overcome it eventually with the nasal pillow.  He said it did take time and patience, but it is doable.  Lord help me but I pray that the surgery will aid in getting rid of the sleep apnea altogether.

Speaking of the surgery, I'm feeling really antsy.  It is months away and I just want to get going with it already.  I know a big part of that is that I've been having some really major body image issues coming up lately.  This morning when I was changing my clothes and looking in the mirror, I focused on my thighs.  The excess on my upper thigh feels like a growth to me, even though I know in my head it is not.  I recently watched a program on TLC, Half Ton Killer, and I know I am comparing my body to hers.  It's the story of a woman who weighed over 1,000 pounds and was accused of killing her little nephew by accidentally rolling over on him while babysitting him.

Obviously I don't weigh 1,000 pounds.  I just sat there staring at the screen and looking at the mass of flesh surrounding her, feeling so broken-hearted for her but also feeling as though I am the same way.  There are so many physical limitations that she has that she is now bed-ridden.  I wondered how she could get to that extreme point without doing something about it, but then realized I am in the same situation.  Sure, it's not as drastic as hers, but it seems like I closed my eyes one day and wondered how all the weight piled on without me really recognizing how bad it had gotten.  Obviously I saw what was happening, but I guess it just goes to show me how much of an addiction food is to me, just like alcohol is to the alcoholic.

Whether this was before I went on Optifast or after the weight came back, the devastation is still just as strong.  I just don't want to feel the physical and emotional pain of obesity any more.  I don't want to continue putting my life at risk being this size.  I know there is a process I need to go through with the surgery and the next stage of that will happen in about three weeks with me starting the six-months of classes. I just want it now.  I want to close my eyes and fast forward to the time I can have the surgery done.  It's hard being in this body and not feeling shame when I look in the mirror.

Of course, in the meantime, I do have the opportunity to be proactive and do my best to be as healthy as I can right now.  Kaiser has set a goal for me to lose 37 pounds before the surgery, so I'm doing my best to work on that.  Obviously I have to work on the feelings I have going on.  I'm so glad that I was brave enough to seek out therapy because my head is the source of all the negative emotions around body image.  I think it is vitally important for me to continue working with the therapist throughout this entire process.  Otherwise, I am quite certain I'll repeat patterns that got me here in the first place.  I definitely don't want that to happen.

Wednesday, December 25, 2013

Merry Christmas

Hello my four readers!

Yeah, I know there are more than four readers on this blog, but it helps me to be more transparent if I just imagine there are only a handful of people reading.  I write our counseling newsletter at the high school where I work and every time I hit that "send" button, it tells me the number of people it goes out to - more than 7,000 in one fell swoop the last time I looked.  Yet, I must imagine it's only a couple of folks otherwise I'll get into a perfectionist mode and we don't need that out of me.

I hope you had a love and merry Christmas.  Hopefully it wasn't all about the presents but about love.  That's what I think about when I think about Christmas ... God's love for us to give us such a precious gift and our love for each other.  I have been blessed to spend the last few days with my mom.  While it's been hard living with another person and especially a mom for a fiercely independent person, it has also made me grateful that I can have this time with her.  I think of a very dear friend whose mother got ill from cancer right before the holidays a few years ago and passed away a few months afterwards.  She goes through incredible pain during this time of the year, so it really helps remind me that I am supremely blessed to have both my parents and stepmother around.

Instead of cooking, my mom and I decided to go to one of the Indian casinos for dinner.  We took along a friend of hers, who is one of my "aunties" that I have known since I was a little girl.  My mother has a gold card at this particular casino so we were able to stroll ahead of at least 400 people waiting in line to go to the VIP room and we got two meals comped as well.  I didn't do great in having a low-fat meal ... we were in a buffet and I rationalized to myself that it's Christmas.  I know, it's really stupid for me to think that way. I was completely aware of exactly what I was doing.  I'm owning it here though.  I can say that I didn't do nearly as badly as I could have.  Watching people in a buffet is very interesting.  There was crab, shrimp, lobster, steak, etc. and people had piles of food on their plates.  I am so glad I don't live in a place like Vegas with buffets in every direction you turn.

There was this guy that my mom wanted me to meet at the casino.  He's a dealer she has known for years.  She said he had a gastric bypass a couple of years ago and has really gone down in size.  She wanted me to talk to him about his experience while we were there tonight.  It turns out that he wasn't on shift and I said to her, "That's okay, Mom ... I've done a lot of research and talked to a lot of people who had the gastric bypass so I'm feeling really comfortable with my decision."  She then turned to me and confessed that she was hoping to hook me up with him since he broke up with his girlfriend.  I looked at her with a raised eyebrow - now my mom is trying to fix me up?  Seriously??  I had to hug her for being so cute.  God bless her caring heart.

I feel like I gotta run 10 miles tomorrow to work off the food I had today at the buffet.  I commit to being sane and rational tomorrow.  If I go work out, then great, but I will spend no more than an hour at the gym or no more than three miles out walking.  I have to remember what my physical therapists says about overdoing it for my knees and hip.  I gotta heed his advice.  Merry Christmas!

Monday, December 23, 2013

Being an example

I'm in the full swing of vacation and am really enjoying not having to do much.  I'm keeping myself occupied for sure, but I do like the idea of not waking up at 5 a.m.  Let's face it, that pretty sucks!  My mom is with me over a few days this Christmas which is really nice in some ways and, in others, I get to see how I am too independent.  I'm really used to doing things my way, when I want to do them and in what manner.  She just wants to take care of me and I see myself standing in the way, being a bit bull-headed.  I need to let that go and let her be a mother to me.  She did share with me that she is happy for my decision in pursing the gastric bypass surgery and actually is going to talk to her doctor when she sees her next month about getting it done herself.  She really has come to recognize my reasons for pursuing this path - health.  Living healthy and feeling healthy.  I'm so astonished that she wants to do it for herself, but extremely happy at the same time.  She's 63 and I do want her around for a long time.  I don't know how  became a source of inspiration with her in this journey, but I'll take whatever I can get.

Speaking of weight, I've had a rough go of it over the last couple of days.  I have been getting really down on myself about all the weight I have gained back and how much weight I have to lose to be healthy.  It doesn't seem like any of my clothes fit me, or least hardly any fit.  Just carrying in some groceries this afternoon made me realize what kind of damage I have done after years of carrying the weight around.  Even 20 pounds on a person's frame is an extra load on the joints, back and heart.  My seat belt is getting tighter around me in the carrand I'm just a lot more aware of excess weight right now.  Instead of going out and getting a few things that fit, I continue to try to squeeze at what I have.  It makes me tug at all of my shirts and try to shimmy my way into pants.  In a sense, I think it's a way of punishing myself. By not wearing clothes that fit or make me feel comfortable, I am hurting myself, especially the emotional part of me.  Actually, I didn't realize until just now that that is what I have been doing to myself ... being passive aggressive.  After Christmas on Thursday, I promise I will go out and pick up some clothes that actually fit.  In time, I pray I'll get smaller and won't have to spend much time in those clothes.  Regardless, I feel really blessed to have the opportunity to feel better and healthier.  Good health doesn't seem like a lofty goal for many people, but it does for me, that's for sure.

Saturday, December 21, 2013

The present moment

The last couple of days have been emotionally difficult in dealing with the devastating news about my graduate program in terms of working in my district after the program is done.  However, I am in a much better space now.  While the bad news is still hard, I have had great conversations with very supportive friends and have spent a lot time in prayer about this.  I am still going to move forward with grad school with the intention of doing school counseling in the school district where I now work.  I have administrative support standing up against the current policies and, who knows, maybe something will change by the time I'm done with my program.  In the event that nothing has changed, then I will walk in faith, knowing there is place for me somewhere.  A good friend reminded me that God does not give us gifts for no reason.  Perhaps the way we intend to use those gifts will look different, but there is a plan.  The thought of leaving a district in which I have not only attended as a student myself but have worked for so long is very hard, but I never walk alone in any of this.  Maybe there is a place I am needed more than where I am now.  Who knows what the future holds.  All I know is that I need to stay in the present moment and continue walking forward in as much peace as possible.

In other news, I'm grateful that I'm now on vacation for two weeks.  It really is a welcome break, that's for sure.  I'm looking forward to spending time with friends and family as well as just getting rejuvinated.  My mom will be coming to my home and spending a few days with me since she also has some vacation.  I'm glad I can provide a comfortable place for her when she visits.  She rents a room in a mobile home where she lives now since it is about five minutes from work for her, so coming to a place with extra space is something she enjoys.  I know there will come a time, after she retires from work and gets a little bit older, where I will have her come live with me so I'm glad she finds my home so comfortable.  Our relationship has certainly grown leaps and bounds.  There has been a lot of healing there from a childhood that was riddled with abuse on her part and to a honest, loving adult relationship complete with forgiveness and love.  It has taken a lot of work for both of us to get there and I know we both continue to work on it, but our relationship is much more than I could have ever dreamed of than what we had in the past.  God really shows me how wonderful forgiveness can be.

Since my bariatric surgery pre-op classes start next month, I have been doing some more research and just reading more stories of people's experiences with having the gastric bypass. I'm reading a book now where a woman recounts her experience with all of her weight loss attempts leading up to surgery and how it positively impacted her life afterwards.  It is very inspiring and gives me a great insight into what to expect in my own journey.  Of course, every reader of this blog will get to experience my own journey.  I share my experiences not only to be encouraging to other people but to help me as I walk through the challenging days ahead.  I feel that writing is such an incredible tool to help me through emotions instead of wanting to pick up food to help me deal with stress, happiness, boredom and whatever other feelings arise.

As I think about the months ahead and the journey I now find myself on, I realize this is another circumstance in which I need to stay in the present moment.  Otherwise, it might feel incredibly overwhelming.  If you think about it, this is a major thing I am walking through. Having my stomach cut to the size of a thumb and having "rewiring" done with my intestines is beyond intense.  I'm so glad my pre-op classes will be starting in the next several weeks so that a lot of the questions I have will start to get answered.  I have no idea how people who go down to Mexico or somehow do their gastric bypass so quickly without pre-op classes possibly feel comfortable with making such a huge change.  I have gone through a lot of emotions in the process already since the day I decided to pursue the surgery and I know I'll go through more in the 6-8 months ahead.  I'm thrilled I'm not rushing through this process so that I can wrap my brain and emotions around what will be happening.  Thankfully I have such an amazing support system.  In fact, I just told the principal where I work about my surgery and he was incredibly supportive.  He could have reacted very badly because it means I will be missing at least two weeks of work right when we return from summer break.  However, his concern was me and my health.  These are the types of people I am choosing to tell about the surgery, those that will be supportive and not judge me for taking the easy way out (at least in their perception).  This is not the easy way out, trust me on that one.

Wednesday, December 18, 2013

Feelings of grief I think

Today was incredibly painful for me.  Not physically, but emotionally.  I shared yesterday that I was given some potentially devastating news in terms of my graduate program to do school counseling.  I had so many unanswered questions that I decided to send a message to the personnel department to figure out what's going on.  To do the field work required for my master's degree with my district, I have to do it 24 hours per week over three full-time, 8-hour days for the duration of about a semester or so.  I will have to take a leave of absence during those days from my 40-hour per week job.  I am not permitted to do the hours during the summer.  Then, when the time comes to apply, I will have to quit my job and do counseling in another district for a minimum of two years before I will then be allowed to come back and counsel in the district where I have been working for 24 years.

The biggest problem I have is that I already work in the counseling department of a busy high school.  None of the years I have matter, though, not where this is concerned.  I have given so much to the district where I work.  I'm a product of the district and love the work I do.  All I want is to be able to have the opportunity to become a counselor, but that opportunity is just not there.  Not only that but I will have to quit something that I have been invested in for so long.  I have accrued so much time towards retirement, benefits and more. If I leave, that means I will probably have to also leave my doctor because my insurance will likely be through another provider.  It's just very, very difficult to deal with this.

Thankfully I work with some fantastic friends who helped me to look at the bigger picture.  If counseling is important to me, yes perhaps it may not look like what I thought it would but that might also be a blessing in disguise.  I just won't know until I stick my neck out and take the risk.  They are absolutely right ... the point is to be working with kids.  There are no guarantees with anything and so I have to walk forward in faith.

I do have a strong faith, but being a human being is also hard when we often times have fear.  Right now I have a lot of it.  I shed a lot of tears today over this, but I have been incredibly supported by so many people.  My supervisor reminded me of something that fits in with this situation just perfectly:

Be still and know that I am God.  That means I'm not in charge of the outcome.  In fact, I'm in charge of no part of any of this process.  I am responsible for doing my part, but after that it really is out of my hands.  As the day went on, the tears were less and less.  I went from sort of throwing my hands up in the air to stepping back, taking a breath and saying to myself that this is really going to be okay.  Obviously there are so many other battles to fight out there.  I'm not discounting how I feel, but just to get some perspective.

In other news, I received a call from the Positive Choice clinic to schedule my pre-op classes.  That was super fast!  I just saw the doctor yesterday and they were already calling me.  Unfortunately, I missed the call so I won't be able to schedule until tomorrow morning but at least I'm on my way.

A few weeks ago, I completed a sleep study with Kaiser for the sleep apnea.  I received a report in the mail today regarding the results.  I definitely have obstructive sleep apnea and they are recommending the use of the auto-titrating machine (APAP).  The report showed me averaging less than four hours of sleep per night.  No wonder I feel so flipping tired all of the time!  Because of my medical history with this, they do want me to meet with one of the board certified sleep specialists to discuss my diagnosis and any follow-up care I will need.  So I need to make an appointment in regards to that.  I swear, in the last year or two, I have seen more specialists, nurses and doctors for a lifetime.  These are additional reasons as to why I am pursuing the bariatric surgery.  While it's not a cure for all that ails me, it will most definitely help and that's all I've ever really wanted - to just feel healthier.

My highly stressful day

I had a whirlwind of emotions today and I'm still trying to process them.  I have mentioned before that I'm in the process of applying to graduate school.  My goal is to participate in a master's program that will lead to a school counseling position eventually.  I currently work in the counseling department of a big high school.  I love what I do working with kids, so this is just a natural progression to the next step up for me.  I've actually worked in education since I was 17 years old and now I'm 42, so I definitely have a lot of experience.  Nothing can prepare me more for this than what I'm doing now, getting day to day exposure of what happens in high school counseling department.

So I was talking to a colleague who is currently in a graduate program for the exact same thing.  She's about a year in and mentioned to me today she found out that if I want to eventually become a counselor in our current district, my practicum and field hours must be performed three full days per week.  The program requires a total of 600 hours doing that.  Given that I work full time, 40 hours per week, and I would be participating in a full-time graduate program with classes taken at night, I felt like I was sucker-punched.  A friend of mine called her contact at our district office and the person confirmed that I must do three full 8-hour days or I could possibly petition to do four 6-hour days.  Regardless, it must be a minimum of 24 hours per week and they don't want it split up.  The district's rationalization is that interns don't get to experience the full scope of what happens in a counseling department if their time is split up to just mornings or just afternoons.  I do understand that logic, but I already work in a counseling department!  If I choose to do my hours outside of my district, they basically won't hire me.  One of my friends, who is a current counselor and is supervising two interns right now, told me that her interns said the district won't hire you unless you have counseled elsewhere for two years first.  If I do end up counseling somewhere else, I likely will not be returning to my district unless there's a compelling reason to do so because it will be a huge deal to leave my district in the first place and I probably won't want to leave another place.  Never say never, though.

I was pretty upset at all of this news.  I wasn't even at the point of wanting to cry over it.  I was pissed.  The graduate program itself is completely flexible and will let me complete my hours part time or in any way that works out for my schedule.  The issue is with my district and their strictness with those 24 hours.  Am I supposed to take a leave of absence?  Am I supposed to somehow make up those 24 hours somewhere?  It's not as if I don't have any exposure to kids and everything is theoretical for me ... I work with kids everyday and often do many things that a counselor would do.  Granted, I do not handle crisis counseling because there are legal issues around that, but there are often crossover duties.  I did decide that I'm going to contact the personnel department and talk to them about my concerns.  My friend that told all of this to me today is a teacher, so the way things will work out for her schedule-wise is different than my situation.  Regardless, though, we both have to face the fact that, if we move forward in the programs, we will have a huge cut in pay.  I'm a single person who has no other income than my own, so I'm faced with having to make some very touch decisions to survive on 16 hours per week of pay.  Excuse my language, but fuck!

With all the stress of that churning in my stomach, I had to leave work a little early and then head to my appointment at Kaiser to meet with the program doctor who would be reviewing my test results and discussing whether or not I would be officially accepted into the program for weight loss surgery.  I didn't know what to expect, so I was feeling anxious with butterflies churning in my tummy.  When I checked in at the Positive Choice clinic, I was asked to weigh myself and then have a seat to wait for the doctor.  I have gained a couple of pounds.  I didn't know if that was a true gain or because I had been drinking water all day, which always adds weight.  I got recorded at 371.5, which was pretty difficult for me.  My lowest weight I got down to when I was doing Optifast about a year ago or so was, I think, 220.  As I sat there waiting, I had to remind myself not to beat myself up over the number because I'm there to get healthier, not berate myself.

The doctor came and got me and brought me back to his office.  I looked around and noticed all of his diplomas, awards and news articles about weight loss and surgical options on the walls.  There were drawings of the differences between the different weight loss surgeries as well.  He began by discussing my current BMI, which is calculated to be about 54.  He said the program requirement is to have a BMI of 40 so I more than qualify on that front.  Fantastic Kathy (can't you detect the sarcasm?).  Then he started asking me about my diabetes, whether or not I inject insulin, my osteoarthritis, the pain in my legs and fibromyalgia, my history with high blood pressure, sleep apnea, depression and all the medications I take.  He told me I am an excellent candidate and congratulated me since he is approving me for surgery.


All the stress of the day went away in that moment.  I am now officially on my way.  He does recommend the gastric bypass surgery for me since that is the one where I can lose the most weight and most of those patients have their diabetes go into remission.  He did explain that my diabetes will never be reversed or go away, but the remission will make it so that I won't appear to be diabetic any longer as long as I follow the program.  When I discussed with him the difference between the gastric bypass and the vertical sleeve, he said the sleeve does not allow for as much weight loss and the not as many patients have remission of their diabetes.  The lap band does not reverse the diabetes at all.

The next step is that one of the nurses will be contacting me in about a week to put me in a class.  Since Carrie and I want to do the class together, I'll be choosing the one that is closer to where I live.  The only bummer is that it doesn't start for another month.  However, unless they have a class starting this month, that's the one I'll do.  The doctor did say that about a month before the six-month pre-op classes are over, I will be contacted by one of the surgeons at Pacific Bariatric to meet with them.  The surgery will happen about a month after I finish the classes.  That will bring me into about mid-August in terms of having the surgery.  The doctor did say that I will be in the hospital for two days to make sure I don't have any complications develop and then I should be back to work within two weeks since I don't have a highly physical job.  He did tell me that, in terms of my weight, we want to aim for me losing about ten percent of my body weight prior to surgery or at least maintaining where I'm at right now.  They don't want me gaining but staying the same is okay, too.  So here I go!

Sunday, December 15, 2013

Alright, much better today

I walked into today knowing that I had let go of my mistakes with snacking on junk last night instead of having a real dinner.  Writing about it on here really helped tremendously.  In fact, when I was walking with Sara today, she mentioned that I'm an open book on here.  I have to agree with her.  I pretty much put it all out there.  For me, this is a real journey to let go of the weight and part of that process is dealing with the emotions that come as a result, otherwise I will continue to use food as a crutch.  So I vowed to myself when I started this blog that I would be as transparent as possible.  I'm not as brave as some other people when they post pics of themselves with just underwear on or just a workout bra and exercise pants on because, personally, I think that's going a bit too far beyond my comfort zone.  Writing, though, releases so much and helps me get down to true feelings.

After walking at the lake, I spent some time working on my backyard.  There are these huge trees right over my house and they shed a lot during the winter, so there were leaves galore.  I managed to fill two big trash bags of just leaves, but it felt good to clear a good portion of it.  My back was hurting from doing all that bending.   The big reason I am pursuing weight loss surgery is to feel healthier.  A contributing factor is the pain I feel all over my body, including my bad back.  I know that having less weight to contend with will really help alleviate much, if not all, of the pain I feel in my back.  I do know my limits and had to stop, even though I saw weeds I could attack.  It was enough work back there.

My dinner was a stir fry in extra virgin olive oil of
turkey sausage, carrots and yellow bell
pepper over quinoa.  Yummo!
I did much better with my meals today, having them at regular intervals.  I weighed and measured every single thing that went into my body, which was great because then I knew exactly what I was consuming with no guessing.  Some people really hate weighing and measuring, feeling like they are on some sort of diet and having negative feelings associated with that.  For me, there is a certain sense of freedom that comes with weighing and measuring in a weird sense.  It lets me know that I am having what I'm supposed to be having for my good health.  That doesn't mean I can't have fabulous food, just an appropriate amount of fabulous food. I tracked everything into MyFitnessPal, including my water consumption.  I had 72 ounces of water, which was good, but I'm trying to aim for about 100 ounces or so a day.

One of the things that was alarming, though, was my blood sugar level.  I made a really awful decision early in the day in regards to that.  When I woke up first thing in the morning, my blood sugar was 275.  Gulp.  I knew it was because of what I did the night before.  When it was time to inject my insulin this morning, instead of my usual six units, I increased it to 30 units. I can already hear you wondering what the heck I was doing, that it's an incredibly dangerous and, frankly, stupid thing to do.  Clearly I was wanting to get it down badly.  After I came home from the walk with Sara, I checked my blood sugar again and it was 170.  I was pretty surprised it wasn't in the normal range yet after having walked almost three miles.  Of course I didn't think about the fact that it went down 105 points.  However, by the time I was ready to make my dinner, I felt extremely shaky and was starting to sweat.  I instinctively knew my blood sugar had gone too low.  Diabetics know their bodies and can usually tell if blood sugar levels are too high or too low. I pulled out my meter to test and it showed me at 61.  Shit!  Hmm Kathy Jean, do you think that perhaps injecting 30 units this morning was the smartest move you've ever made??  I stopped what I was doing to have a piece of bread so that I could get my blood sugar up.  I contemplated just waiting until my dinner was ready but I was so shaky that I worried about using a knife to cut my veggies.  Everything is fine now and I feel good.  I usually have two Glyburide pills with my dinner to help control my blood sugar but I decided to forgo them since I was so low.  Note to self:  do not do that again.  Duh.

Saturday, December 14, 2013

I was doing good until ...

Today I did a great job at logging my food, got enough water in my system and even logged in my exercise to MyFitnessPal.  It definitely keeps me very accountable.  I am working at really being aware of patterns or being more alert as to when things are difficult so that I can do the best I can to shut all of that down right away instead of letting things fester so that I eat over them.  Emotional eating is horrible because it really seems to come out of absolutely nowhere.

Okay, it wasn't as bad as eating all of this, it just felt like it.
But, how do you handle it when everything is going well and then, when you get home from a busy day, you feel like the cookie monster in the kitchen?  That was me today.  I was planning on coming home from church tonight and was going to make a very sensible, healthy dinner.  That wasn't in the cards for me, though.  Ha ha, I almost said it wasn't in the carbs for me - Freudian slip like no other!  I ate some chips, bread and nibbled on some chocolate.  Obviously that's not good.

I'm trying to figure out why all of that happened.  The best thing I can see, and really it's a good explanation (although not an excuse), is that all of my meals were off today.  I had breakfast at almost 11 a.m. and lunch at 2:30.  I even had to sort of force myself for lunch because I knew that I would not get back home to make dinner until 7ish.  As it turned out, it was closer to 8 p.m.  I was pretty hungry at that point, so I made horrid choices.

Breathe, Kathy, breathe.  Yes, I made choices I wasn't happy with but I don't have to carry them further into the evening or tomorrow.  I'm saying that for myself more than anything else.  I don't want to beat myself up over regrettable choices.  It happened, there's nothing I can do to erase anything, so I pick things up and move on.

Tomorrow I will be seeing Sara to go for a walk in the morning - looking forward to it girl - and then I plan on spending some serious time working on my grad school application.  I have about five weeks until it's due, so I want to work on my personal statement so that I'm not feeling rushed.  It's important to me to do a great job on that since it's something that's very important to me.   Time to wash my hands of my bad eating this evening and continue moving forward.  That's the best I can do.

Friday, December 13, 2013

Surprising result

From the lab work that was done on Monday, I thought I was done with all the tests they were going to do with my blood.  Wrong!  I happened to log onto Kaiser's patient website to look at when my next appointments were and found this message that was sent to me before a received an e-mail notification:

"All of your lab results look good, except for your vitamin D.  Your vitamin D level is low (24):  Normal range is 30-100.  A prescription is entered into the computer for you to pick up at any Kaiser pharmacy for vitamin D 50,000 units by mouth to take three times a week (or every other day) for 6 doses.

"You should also be taking over-the-counter vitamin D3, 2000 units daily as a routine supplement.  Continue taking the over-the-counter dose after completing prescription.  You will need to check lab again (vitamin D, PTH, calcium) after treatment.  Orders have been entered for non-fasting lab to be done the week of March 10th.

"You may also find the following website contains helpful information and you may purchase supplements designed for bariatric patients:"

So after reading all of that, the thing that struck me first was the part where she mentioned purchasing supplements for bariatric patients.  I wondered to myself, "Am I a bariatric patient now? Have I been okayed to move forward?"  These are legitimate questions, but probably most people would focus on the deficiency part first and worry about the bariatric label later.  Not me ... impatience rearing it's ugly head.

Back to the vitamin deficiency, I wondered how I could possibly be lacking in vitamin D.  Usually that's for people who don't get enough sunlight.  I do try not to bake in the sun since having melanoma, but I also don't hibernate indoors either.  I know it's winter time, but I live in southern California - there's generally always sunshine of some sort.  I went online to Web MD to see if I could find out what was going on.  What I saw made sense: of the various symptoms, I qualify in two areas - have darker skin and lactose intolerant.

I went to the pharmacy and picked up the prescription.  Pills with 50,000 units of vitamin D seems like a lot, but I'm sure that's just to get my levels back to where they should be.  I always think to myself that I have too many pills to take, but that is incredibly laughable because, after I have the gastric bypass, I will be taking vitamins for the rest of my life.  I am sure I will get rid of most, if not all, of my other pills as my health improves in the future.  I need to do what I need to do to get my level back to normal, so no big deal in the big scheme of things.

Yeah, so that didn't work out

Alright, so my first attempt at changing the look of the blog didn't exactly work out. There was a design flaw in the other template I had up so that my extra pages didn't show up like they should have. So I switched to a different format. It's still cute so it's all good!

I used to be the webmaster at my work site, although my technical skills with that extra job duty were probably intermediate at best. When you work at a high school, at least in our district, you generally don't have someone on staff at a high school as a webmaster being their primary job duty. Most of the time, it is an add-on while there is one district webmaster with that as her primary responsibility.

As such, I was never trained in too much detail in writing html code. I figured out a lot of things as I went along and have used some of it on my own blog here. I am trained in and experienced in the field of education, so you'll have to forgive me as I figure things out here with other design flaws. There are widgets appearing on the page that are not easy to delete so I have to go into the coding to figure out what I can delete without deleting necessary design features.   Sounding too technical, right?

I have to be forgiven for that ... it's 2:42 in the morning and I'm up because my tummy is really hurting. I'm feeling a little jealous of my kitties who are having absolutely no problem in sleeping right now on my warm electric blanket. Hopefully the bad feeling will pass soon and I'll be able to get some sleep.

Meanwhile, I'll continue to play with my website ;-)

Thursday, December 12, 2013

What, another change?

Yes! I like to keep things fresh so here's a new look to my blog.  I'm still trying to figure some things out, so there might be some minor changes but I decided that as I move into a new phase (surgery) of my journey to living a healthier life, it was perfect timing.  The woman at the top represents me springing out of this body that hides a fresher, more confident, sexier, much more free Kathy.  I found out yesterday that my melanoma biopsy is benign (YIPEE!!!) and so it's time to celebrate ;-)

Speaking of my surgery, I found out more information in terms of my next steps.  I had an evening workshop to schedule at work with some families in January, so wondered when my gastric bypass pre-op classes would start, provided I move to the next step.  They take six months and I didn't want to schedule a workshop the same night I have those classes.  I thought maybe I should just wait for my appointment with the doctor in charge of the Kaiser clinic since that's just next week.  Yet I realized it would not only be meeting with him but then waiting for the referral to get back to the program director and then finally scheduling something.  Or I could just call the program director and find out details right now.  Yeah, that sounded much better.  That way, I could plan my workshop and also find out when things get rolling on the classes.  Okay, if I'm being completely honest, it was probably more about finding when the classes start because I'm anxious than the workshop I need to do in January.  I just can't wait!

I called and got to speak with the director.  I told her I've gone through the orientation, did all the lab work and will be meeting with the doctor on Tuesday.  She sounded surprised I'd gotten so far so fast.  Well, I guess when you're feeling determined, you'll do whatever it takes to make it happen.  I knew that the choice is up to me in terms of how fast I want to get going. The classes will be starting on Monday, January 20th at 5pm.  My classes will be on Mondays, right after work, so that's perfect.  Even better, I get to do it at the facility closer to my house and I also get to do it with my new friend who is going through the same program.  I can't even express how excited I am about all of this.  I'm also so grateful I will not be doing this alone.  The support system I have going on for this is so much bigger than the one I had for Optifast.  It's been pretty amazing.  I haven't even told that many people outside of those that are very close to me.  I'm sure in time I will share it with more people, but for now I'm holding it close to the vest because this is very personal and I frankly don't want any Negative Nancy's bringing me down.  I had enough of those with Optifast.  As strongly as I felt about that program, I feel even moreso for this one.  After everything I have tried, it feels right for me on some very deep level I can't quite express.  But I think you get it.

Tuesday, December 10, 2013

Some great news

After a pretty crazy day yesterday, all of my results from the tests I took posted in my Kaiser online account.  Thankfully, I appear "normal" (relative, I know!).  I received a call from the Positive Choice clinic and an appointment has been scheduled for me to meet with the program's doctor.  There he will be doing an evaluation of all of my medical records and background to determine, with me, which will be the best surgery option given my history.  I really have gotten a great insight into how much it means to me to have the gastric bypass  when I thought I might not make it through the questionnaire phase.  I have to stop this black and white thinking because I was convinced one wrong answer and I would be out on my bootie.  So I see the doctor next Tuesday and I think I'll have more definitive answers at that point as to what the next six or so months will look like for me.  If only I would hear back from the dermatology department on my biopsy!  I am feeling much better about it today.  Perhaps it was the pain of the area the doctor cut out of my back, perhaps it was because it was very close to the melanoma site ... whatever the reason to cause me a bit of anxiety, I'm feeling much more relaxed today.  For the rest of the night, I will be relaxing next to my beautiful Christmas tree. I always am reminded of past Christmases, making ornaments, wrapping presents and feeling the wonder of Santa that childhood brings.  I really have always loved the season and I think I'm finally getting in the spirit.

Monday, December 9, 2013

Are you freakin' kidding me?

Today was one of those days where I was afraid the phone would ring to tell me one more thing that might push me over the edge.  Today, I had a scheduled physical therapy appointment at 7:00 a.m.  My intention with scheduling an appointment that early was to get in and out without missing too much work.  Wrong!  I received an e-mail late Friday from Kaiser telling me that I was now ready to move on to the next step towards the bariatric surgery, so I would need to get lab work and an EKG done.  I figured I would just do those things at Kaiser while I was already there for the PT appointment.

I had a great session with the physical therapist.  It actually was my last one with him.  I've been doing really well with building strength in my leg that the PT and physical medicine doctor both told me to continue with the exercises and try to incorporate some low-impact exercise.  If I need to see them again, I can but I wouldn't need to make up a follow-up appointment.  When I was laying down on the bed so that he could show me the new exercises, I can say I felt really sad.  It had nothing to do with the PT appointment, it was just painful laying on my back because of the pain from the biopsy.  I did tell him that and so we talked about the melanoma.  He was very empathetic, which was sweet, but it was almost my undoing.  I just had thoughts about what's going on inside of me, pondering the what if's about the possibility of having cancer again.  In my head, I am doing the best I can to let it go, turn the fear over to God and try to just be in the moment.  Then there are other times where my heart takes over and I somehow feel that the doctor is going to tell me the biopsy turned out malignant and that the cancer has returned.  Every time the thoughts enter, I try to do the best I can to expel them but they keep coming back.

After I was done with the physical therapy, I went over to the lab department.  That is where I had to do a urine test and have blood taken.  They ended up taking seven vials, nothing near what I thought they would take.  They also gave me the container for the stool sample.  Yuck.  After I was done with giving blood, I waited a long time to do the EKG because they were squeezing me in between appointments.  I followed the nurse to a room and was told to lift off my shirt and lay on the bed.  Geez, aren't you gonna buy me dinner first? That's what it felt like - get in, take off your shirt and lie on the bed.  Whatever.  She put the sticky circles on my arms, abs and chest while I laid back and stared at the ceiling.  About two minutes passed and then she told me I was all done.  That's it??  It felt like the build-up was longer.

I had to refill a pain med from my dermatology visit on Friday but the pharmacy was closed so I decided to go home in between to take care of the stool sample and bring it in.  You're required to put it on ice, so since I live near another Kaiser facility, I could do that and then hit the pharmacy before finally heading into work.  I did keep my boss appraised of everything going on so she wasn't wondering where I was.  I'm sorry if I'm talking too much about stool samples but you'll understand why in a minute.  Anyway, I packed ice around the container and headed over to the lab at this other Kaiser center.  It was full of people, in fact it was pretty packed.  I went up to the receptionist in the lab department and discreetly told her I was turning in a sample.  She told me she would call the lab and let them know.  They didn't pick up so she went to go talk to them.  Then she says, from the other side of the counter where other people can hear, "She said you can just go ahead and leave your sample in this container."  So I walked over there with my head held up, knowing the entire room heard what she said, and put my bag quietly where she pointed.  I asked her if I needed to speak to someone, she said no, so I wished her a good day and then turned around to walk out.  Every pair of eyes in that room were looking right at me.  Some of them had that look on their face of, "Ew, is what is in that bag what I think is in it?"  It's hard to hold your dignity in moments like that, but I managed.

While I was over at the pharmacy waiting for my prescription to be ready, I discovered a had a call on my voicemail from Kaiser.  I suddenly thought to myself, "Oh no, is this the call from Dr. K telling me that the cancer has returned?"  Dreading to know what the call was about, my voicemail did contain a call from one of his nurses.  She said, quite forcefully, he wants to see you today, this morning and that she had already booked a 10:45 appointment for me even though she knew I was in another Kaiser facility that was a good distance away.  My heart sunk as I called back to confirm.  I texted my boss and let her know what was going on.  After the prescription was ready, I got back in my car and drove down to the appointment.  By the time all the Kaiser visits were all said and done today, I drove about 50 miles between all of them.

When my doctor came into the room, I suddenly remembered that I had sent him an e-mail yesterday.  The reason was that I was going to change the nail polish on my toes and noticed a really dark black mark on one of them when I removed the existing nail polish.  I guess the color had covered it up.  So my e-mail was very casual, asking him if I should take a picture of it for him to look at it, if we want to wait for my next appointment or what I should do.  I realized, in that very moment, he wasn't going to deliver cancer-has-returned news to me - he wanted to look at my toe.  OMG, I can't even describe the amount of relief that flooded over me.  It was intense!  After looking at my toe, he didn't think it was cancerous.  He thought I might have trauma to my toe and that it's just a bruise under the nail.  I didn't hit my foot recently, so I didn't think that was it but he explained why he thought the way he did.  The two options he gave me were (1.) perform a biopsy through the nail (yeoouch!!!) or (2.) monitor it for 2-4 weeks and then perform a biopsy if it hasn't gotten better.  I can't tell you how fast I told him I would be going for option two.  The thought of doing a biopsy through my nail or having to remove the nail to do the biopsy sounded incredibly painful.  I would also not be able to wear shoes for a while and given it's been in the 30's here, that's just not something I want to try first.

After all that, I finally went to work.  All of the emotions I am going through these days is immense.  I have had more Kaiser visits recently than I had during the course of an entire year in the past.  These are all proactive things I'm doing for my health, but I do feel very overwhelmed right now with these intense feelings.  Is it cancer?  Will I be approved for the gastric bypass surgery?  Do I have to take more tests?  How much weight do I have to lose before surgery?  Oh my gosh, it's a lot.  On top of that, we're incredibly busy at work and I feel guilty for being away.  Yes, I know they are all medical appointments and, yes, I have an incredibly supportive boss and co-workers who think highly of me, but my work ethic tells me I'm missing too much time away from work.  I have to keep remembering, though, I'm doing all of this to be healthy with a better quality of life.  I have to keep remembering that.

Saturday, December 7, 2013

A cut for me is a good thing and moving on to the next step

I had an appointment to see my dermatologist yesterday.  I got a call from his office over the Thanksgiving holiday to tell me I was on a waiting list to see him for a routine 6-month melanoma follow-up appointment in February.  I told his nurse that would be fine but to please let him know I have been experiencing pain around my incision site.  I didn't realize that little comment would spark an immediate phone call by the doctor himself (which never happens with my HMO unless it's to tell you bad news) followed by a next-available visit with him.  What's basically been happening is that I have been having significant pain and tingling at the tip of my back scar from the cancer surgery and it had been happening all of a sudden so I was concerned.  He ended up looking at it and prescribing some steroids for me to help with the pain.  While I was there, we did my regular appointment so that  wouldn't need to wait until February.  That entails a full body scan.  It's a less than thrilling appointment because the doctor looks at you from head to toe, literally.  He found two moles that are "concerning" to him in addition to taking a biopsy from my back where a spot had grown in size and changed shape.  So now I have a portion of my back cut out a few inches above the surgery site and it huuuuurts. The way they do it when you get a skin biopsy is they give you a shot of a local numbing agent and then essentially take a blade and shave off the area.  The size he cut off my back is about the size of a thumbnail.  When the shot wears off, you're left with a lot of pain.  So that's been sent off to be evaluated.  Meanwhile, the two moles he found made him very silent when he was looking at them and told me to diligently watch them.  That didn't sound good.  However, I'm trying to stay as positive as possible and be guided by my faith.  I've had two other biopsies that ended up perfectly fine so I'm assuming this one will as well.  As for the other two moles he saw today, I don't want to think about worst case scenarios because, right now, they are just little moles.  With my skin type, I have dark freckles that make it hard to distinguish sometimes between that and a mole.  I do have to say that, with all of my experience in dealing with a dermatologist, I have a great respect for the profession.  When I was younger, I had the misinformed perception that all a dermatologist really did was give botox injections and maybe help with acne.  I couldn't be more wrong!  It was a dermatologist that saved my life - if he had not treated my melanoma as seriously as he did, I wouldn't be here today.  I'm so grateful for my wonderful doctor and his empathy with me.

In other news, I received a message from the Options program that I am moving forward towards the next step of the weight loss surgery process.  I have to go get lab work done now.  That includes give lots of vials of blood samples (someone told me it's over 20 vials but I have a hard time believing that's true), a urine sample, EKG and providing a stool sample.  That last part makes me less than thrilled but, whatever, I gotta do what I gotta do.  I'm really happy I can keep moving forward.  For some reason, I had myself convinced that they would reject me from my answers in the questionnaire.  I know it's silly, especially given I have co-morbidities that make me the perfect candidate for the gastric bypass, but I have to be honest that it was a concern of mine.  I have discovered how very much I want to pursue this surgery that any disappointment along the way, perceived or actual, affects me greatly.  I found a really great group on Facebook that is a great source of support.  If you're interested, search for "Gastric ByPass Surgery Stories".  There are about 5,000 people in the group and the only people that can see your posts are other members, not everyone on your Facebook friends list.  It's a really active group with great before/after pictures, advice and people sharing their experiences.  I have come to really understand how absolutely necessary positive support is for long-term success with the surgery.

Thursday, December 5, 2013

Happy birthday to me

I had my birthday yesterday, turned 42.  I felt so much love from my family and friends, it was actually overwhelming.  I'm not sure if "overwhelming" is even the right word.  I just had so many people giving me smiles and hugs that day that I wish every day was a birthday!  I know I'm not old, but I did think about the fact that I'm not an 18-year-old kid any longer.  Somehow, without me even realizing it, I became an adult that kids look up to as a role model and mentor.  During dinner, I did tell a friend that I'm pursuing the gastric bypass surgery.  She cried when I shared my news.  It actually was shocking to me because she is not the first person who has cried as a response.  In that moment, I suddenly understood how my weight has not only impacted me but other people.  Here I am just dealing with my own feelings about undergoing such a life-altering surgery that will leave me forever changed that I never even went down the road of considering how it impacts other people.  As much as I have suffered, so have they.  It's hard to watch someone you love be in pain and I realize that it's exactly what they have gone through.  The tears that I have watched people shed as I have shared my decision with them has been about their care and concern for me.  I guess I forget how much I mean to other people.  I'm not saying that in an egotistical way at all, but the people that love me do so for a reason, just as I do for them.  When I was younger, I used to wonder if I really meant anything to other people.  It's not as if I was suicidal, but I had myself convinced that no one could really care that much about a fat girl like me.  It's horrible the things that go through our minds.  There is not one day that passes now in my life that I can't recall someone telling me they love me.  Sometimes I really get down on myself because I'm not in a relationship with someone, that somehow I'm not worthy to be loved by a man again.  In those moments, I get into that black and white thinking and then someone comes along and says, "Kath, I love you."  Talk about touching your heart!

My sleep study to be fitted for the CPAP is continuing.  I finally broke down and called the pulmonary department to say, "Hey, I can't sleep with this thing ... HELP!!"  So we talked about some things I can do to sleep on my side without the mask slipping off my face.  That seemed to help because I actually got some sleep with it on yesterday.  I didn't sleep the whole night through, but I got about three intermittent hours in with the mask on my face.  That's actually a really big step up for me.  I did take it off, though, and slept the rest of the night away to ensure I could at least be functional.  It's very difficult to function without enough sleep.  In fact, when I saw my therapist today, we talked about what untreated sleep apnea can do to someone who suffers from the condition.  It actually was scary to realize what an incredible danger it is.  I had my eyes opened when she told me I could have heart disease that possibly could kill me in the middle of the night from the lack of oxygen, I can get high blood pressure, and I increase my risk of getting in a serious car accident.  When I asked her about the heart related issues, she went on to explain that it severely impacts your oxygen level which could be a problem in regulating blood flow to and from your heart as well as to your brain and you're more susceptible to having a stroke as well as atrial fibrilation.  I had no idea how truly serious it is so that made me more committed than ever to being patient with the process of sleeping with the mask on my face or, hopefully in the future, the nasal pillow in my nose.  I want a long, healthy life so I'm doing whatever I can to be proactive in that regard.  Sometimes that's difficult, but I also need to remind myself in the moment that these things take time.  Being patient with myself has never been something that comes easily, but I know all I can do is put one foot in front of the other.  I have to remember that as I go through the process of adapting to the machine as well as the surgery ... just one foot in front of the other, that's all I can do in the moment.

Tuesday, December 3, 2013

I actually do laugh at myself

Yesterday was such a busy day that I meant to post, but it just didn't happen.  I had two important Kaiser appointments.  One was the Lifestyle & Weight Management class.  If you are planning on going through weight loss surgery, one of the classes you are required to take in the beginning is this particular class.  They talk about portion control, planning meals, label reading and more.  You are actually given a sample meal plan to follow if you want to lose weight.  The dietitian brought in some of that rubber food that looks like the real thing but really just demonstrates what sizes are when trying to eat in a healthy manner.  It was a good class and I'm glad I went because I picked up some great tips that I can incorporate into my life beginning now.

The other appointment I had was to go to the pulmonary department and get instructions to start my next sleep study.  It's my third one.  I can't even express how much I'm dreading it because I just can't freakin sleep with the CPAP mask on.  However, I have to get on the machine.  One reason is the weight loss surgery requires it if I have a sleep apnea diagnosis.  The other reason is that, if I can manage it, I actually will sleep better.  At least I pray that is a result.  My problem is that I can't sleep on my back.   I will lay down and then, just as I'm falling asleep, I'll start to snore and then wake myself up.  So I generally resort to sleeping on my tummy.  That usually isn't a problem but, given that the gastric bypass is done on the tummy, I won't be able to sleep on it so I'll have to figure something else out.  If I'm being perfectly honest, my biggest fear around the CPAP machine is that I will be one of those people that just can't sleep with it no matter what.  However, I'm trying to take it a step at a time with that.

So, when I was in with the technician, I asked her if I could please use the nasal canal machine.  It just connects into your nostrils and does not have the gas mask.  Okay, so it's not really a gas mask, but it sure feels and looks like it.  She basically told me that she does not recommend that machine because it has a tendency to slip out of the nose and is a problem.  She asked me to please give another device a try and then go to that one after 6 months if I still want to pursue it.  I told myself that I would at least try what is recommended.  So there were two options - one with a mask covering your nostrils and one with a mask covering both your nostrils and mouth.  Sounds lovely, doesn't it?  I have to give a visual reference.  Below is a photo I had posted before I found of a person with a CPAP mask on that I found hilarious because it reminded me of Hannibal Lecter.

This mask is the one covering both your nose and your mouth.  The advantage of this machine is that you don't have to worry if you ever sleep with your mouth open.  However, my machine just covers my nose.  I have a lovely chin guard to wear that will keep my mouth closed.

Ready for a picture of what I will look like going to bed?  I know you're just dying to see it.

Are you sure you're ready?

This image will be one you won't be able to get out of your head. Ever.

Wait for it ...

Wait for it ...


Ha ha!!  Tell me that isn't hilarious!  I purposely tried to look like the man in the other picture with my eyes wide open.  When I showed it to a couple of other people today (I took it last night), we were laughing hysterically in howling laughter.  I just thought to myself, "Oh, that is attractive!"  It just seemed so ridiculous to me.  You can't even see the special chin strap, but that's just like the icing on top of the cake.  At least I'm laughing at myself ;-)

All kidding aside, there were moments when I got very sad as I was getting instructions on how to do the sleep study.  My sleep apnea is in the "severe" category, I believe the worst level there is.  There was a moment when I wanted to put everything back in the bag and run out of the room.  I wondered to myself if this is some sort of punishment towards me for years of having problems with overeating.  Did I do this to myself?  I just felt really, really bad in the moment.  I did remember, though, that this is a process and I am going to be just fine. The gastric bypass will really help with this, maybe even reverse the condition similar to what will likely happen with the diabetes.  I need to remember to breathe and pray that God give me strength through all of this.  I did try the machine last night and, after two hours of attempting sleep, I finally took it off so I could at least get some sort of sleep to be functional today.  I'm going to try again tonight, though.  I'm not giving up.  Besides, the technician said that there are lots of things they could do, even send me to a formal sleep study where they monitor me overnight.  So all is not lost and I don't have to think about it in such a black and white fashion.  I always said my goal was to be transparent here and I wasn't kidding.

Sunday, December 1, 2013

Let's talk about it

There are some addictions that are a lot easier to talk about than others ... alcohol, drugs, shopping, sex, gambling.  If there are any addictions that are "accepted" in society, those are the ones.  We all give a look of sympathy as we talk about a man drinking his troubles away at a bar or someone shooting up drugs in a seedy motel.  We feel empathy for them, realizing they have no control when it comes to their substance and pray they can find help.  What happens, though, when we talk about food being an addiction?

I'll tell you what happens ... people tell you to go on a diet, to exercise more, to just push away from the table.  I wonder, though, if those same things could be told to the alcoholic or the drug addict.  What happens if we tell a down-in-the-gutter alcoholic to just drink water, walk away from the liquor store, or just to simply not do it any longer.  Will an heroin addict understand me when I suggest that he just exercise instead of choosing his drug?  Is it really that simple?

Of course not.  The same is true for a food addict.  This is a lot bigger than just calories in, calories out.  Oh my gosh, it is worlds bigger than just that.  Trust me, if it were that simple, we would have no one overweight in this world.  Why on God's green earth would we choose anything other than pushing away from the table if it were that simple versus the consequences of diabetes, painful joints, heart attacks and so much more?  Heidi Powell wrote a great entry on her blog about eating disorders.  After all, it is a disorder.  Ask any good physician and they will talk about obesity as an epidemic that needs serious consideration.

This picture is why I am talking about this today.

I think it's really important to be able to talk about the addiction to food.  I'm not even necessarily speaking about anorexia or bulimia.  Yes, of course they are very important facets in this discussion.  What I think needs to be talked about even more is the bingeing that many compulsive overeaters go through.  It's eating until you are so stuffed you couldn't possibly eat any more only to go back for more once the uncomfortable feeling has passed.  I mean the person that eats ice cream right out of the carton until it is all gone.  I mean the person that puts a smile on her pretty face while her body size continues to grow and grow until she can no longer fit into clothes even in a big-size store.  Those are the people who don't get the attention we so desperately need to give them.  

Those people are me and I am them.

Even if I lose all of my excess weight, my body will always have scars and saggy skin as reminders of where I have been.  Those scars and skin are a cover for a deep internal struggle to feel good enough and pretty enough.  We all have our own issues to move through.  For me, it has been having been abused and raped, along with the ramifications of those actions perpetrated against me.  I was that innocent child above and that got stripped away from me.  I chose to run to food to be my friend and bring me to a different place where I didn't have to think and feel.  It then became habit and a way of life for me that is not so simple as putting the fork down.  The weight loss surgery that I will be embarking on is just a tool.  The real work will need to come from within, learning a fresh new way of dealing with boredom, sadness, anger, joy and all the emotions of life.  That, I feel, is the real challenge for me.  Yet, I know I need to talk about it and bring it out of the shadows and into the light.  So, here I am shining the sun on it.  

Saturday, November 30, 2013

Carrying around two and half bags of pet food

I made it back home from my trip to Vegas with the family. We left last night at almost 6:00 and got home by midnight.  I'm glad I got to spend the Thanksgiving week with them, but nothing is better than being in my own bed again.  I loved meeting my 3-year old niece and playing with her.  Life is so uncomplicated when you're that young. The biggest worry you have is which dress you will wear with your tiara.  As my mom and I spent time together in the hotel room, we got to talk a lot about the gastric bypass.  At first, she was really worried and now she has done a complete 180.  I think the more I was able to answer her questions and we could be honest about any concerns she felt, the less anxiety she felt.  Dr. Oz happened to also have a segment on it and we watched it together.  The issue I have now is her saying, "When you're skinny next year ..." It was always important for her to look good when I was growing up, fat being treated as some sort of disease.  Now that she's older, she thinks it's too late for her so she's now in the mentality to save me from that.  For now, I'm trying to let her be in her own zone about it.  If it persists, I will have to have a talk with her because, for me, this is not about me being skinny; this is about me being healthy.  There is a big difference there for me. As for my father, no, I didn't tell him.  Since he lives in Nevada now for half the year, he is planning on coming down to visit with me at some point this winter.  I think enough time will have passed and I will have progressed further into the weight loss surgery process to talk to him about it at that point.  Of course, I'm going to take it one step at a time and play it by ear and see how comfortable I am by then.

After getting back into a regular routine, I did run over to Costco to get some veggies and restock my cat food and kitty litter supply for the girls.  I buy a 25-pound bag of cat food that lasts well over a month for them.  As I was carrying that in from the car in both my hands, I was amazed at exactly how much 25 pounds really is when I think about it.  My highest weight is over two and a half of those bags on my body from where I am at right now.  If ever I don't think it's a big deal that I'm keeping off 60 pounds from my highest weight because I'm too focused on dropping bigger numbers, I just have to think about how it felt to lift one of those bags and then imagine adding another bag and a half.  How do we do that and not even notice how really bad that is for our bodies?  I couldn't wait to put that bag on the kitchen counter and have it removed from my arms.  No wonder it's such a big deal when doctors say even losing something like 10-20 pounds is so important for our hearts, legs and back.  Yeah, I totally get that.  Now how am I supposed to bring in that 42-pound bag of kitty litter??  Gotta love Costco.

Wednesday, November 27, 2013

Geez, patience is not my virtue

Today was an interesting day for me.  I got together with my dad, stepmother, stepbrother, his wife and their child.  My dad has a friend here who has a house where he always stays when they visit the area since his friend is in another country.  My dad has been trying to buy the house from him at a discounted price since it would be a nice little winter home to get out of the snow of Utah.  So I found the house today and when I walked in, everything seemed familiar somehow.  His particular friend was in Germany when my dad's job was also in Germany, so I figured they went around to some of the same places.  But then, as I'm looking around, everything seemed weird.  I turned to my stepmom and said to her, "Did you guys buy this place?  It looks like all of your stuff in here."  Turns out they did!  So they will be living about five hours from me half of the year!!  I'm really excited.  Although, I have been told not to share this information with my brother and my mother.  That puts me in a weird place, so we'll have to see how that goes.

Speaking of my brother, he dropped a bomb on me yesterday.  He and my dad have not been speaking for about three years.  My dad has made attempts but my brother has been unresponsive.  He told me that he's going to call my dad so that they can get together this weekend.  I have been praying they mend fences.  Of course, everyone has to do it on their own time when they are ready, just as my mother and I had to do.  The only difference with our situation was that it took us 12 years to come together.  I told my brother all along that the pain of that is really indescribable.  I pray that God gives them both courage to be honest with each other about whatever it was that has kept them apart.  I do know God answers prayers, so this one was especially touching.l

While visiting with my family today, spending time with my niece, it felt good to be around them.  My little niece is three and it was the first time meeting her, so she was a little shy with me at first.  That lasted for a good five minutes before we were putting puzzles together, painting, going down slides together and so much more that wore out this girl.  [By the way, Sara, she calls me guppy, too, just like Max ;-) ] All the activity with her just reminded me of how uncomfortable it is being a larger person in the world.  I can't get down on the floor with her and play like I would like to.  Lifting her takes effort after a few times.  Running up and down the stairs in the house was a real pain to my knees.  In fact, I was on the verge of telling my dad and stepmother about my decision to go with the gastric bypass surgery an incredible amount of times today.  I would think to myself, "Is this the moment?  Is this the one??"  Of course, I just posted yesterday about wanting to wait to tell my dad.  Nothing has changed in that regard but I am impatient.  Most of you have probably already figured that part out by now.  I want things when I want them.  I don't like waiting.  I even called the director for Kaiser's Options program to make sure she received my questionnaire.  She called me back letting me know that they have already processed my questionnaire and it is now in the hands of the medical staff to review before then requesting that I move on to the next phase of the process, which is to get a boatload of labwork done.  I could have waited longer for her to contact me, as they said they would do in the beginning, but I wanted to make sure she received everything she needed from me because I want to know if I'm going to be moving forward now.  Oh my goodness Kathy Jean, you must learn patience.  What can I say ... I don't like waiting!

Tuesday, November 26, 2013

Spilling the beans

If you are considering weight loss surgery, how do you go about telling those you love the path you are choosing for yourself?  Some people will be very supportive, while others will question whether or not you have a brain cell left in your body.  Right now, I'm being very sensitive to how, even if, I will tell someone.  The choice to pursue the gastric bypass is very personal for me and it's a journey that I let others in my life on as I choose.  I've decided I was going to wait to tell my father because, during the last conversation we had about this path, he was dead-set against it.  However, I knew I would tell my mother at an earlier time.  I just didn't imagine that time would be now.

This morning, as I was doing final preparations to pack up my house for the few days I would be gone out of town with my mother visiting family over Thanksgiving, we talked about the medical issues I've been having and what I was doing in terms of how I would be eating over the holiday.  I told her that my doctor is still monitoring me, but that I'm following what the Kaiser diabetes nurse specialist recommends.  Then we talked about my long term goals and I felt that it was the right time to mention my surgery prospects to her.  I told her, "Mom, I wasn't going to tell you about it this early, at least until I am approved, but I have decided to pursue weight loss surgery." I said this to her while I was standing in my kitchen and she was looking at me from the adjoining dining room. Huge mistake.  She started to cry.

I went over and sat next to her and held her hand while she wiped tears away.  These were not slight little tears, they were tears of pain that kept rolling down her face.  There was deep, gut-wrenching pain.  I explained to her that this is a quality of life issue, that I can't keep going down the road I am going down otherwise I might not be here for much longer.  I explained about the Pacific Bariatric Center for Excellence that would be performing the surgery and their success record.   I explained that I have done a lot of research around this and that this is not a quick procedure.  I continued to hold her hand as the tears started to slow down.  It killed me inside, wondering what she was feeling but not brave enough in the moment to ask her.  

Later on, while we were on the road, I asked her if she was upset by what I told her.  She replied that she wasn't upset, but that she's scared something bad will happen to me.  So I went on to explain exactly how the surgery is performed, especially that it will likely be the laproscropic variety.  That eased her mind considerably.  I even brought the orientation book with me and will show her before/after photos of people who have had it done so she understands.  That really helped ease her mind and we could have a good conversation about it.  Her reaction really helped me see that my health doesn't just impact me, it impacts my family as well.  Just as she is concerned that something will happen with surgery, she likely is just as concerned with the weight gain she's seen in me over the years.  I know she always has been concerned, but I suppose this opens my eyes more than it ever has before.  

I'm glad the beans are spilled with my mother, but I also recognize that I simply can't just blurt things out.  I guess, in the moment, I was compelled to tell her but I for sure know I can't do that when it comes time to talk to my father.  That will take some thoughtful consideration on my part.  

Monday, November 25, 2013

Hindsight is always 20/20

I wish I could have do-over on my day.  Of course, things are always easier when you know how it will play out.  I just was so self-critical today and I really don't like that.  To start off, I had an appointment with my physical therapist very early this morning.  There's a table I lie on where he checks my flexibility and I do my exercises with him.  Right across from the table is a big mirror.  When I was done with the exercises, he asked me to sit up and slip on my shoes while he was going to go make me copies of some new exercises he would like me to do at home.  I was very much aware of the mirror so I purposely sat out of view from it.  My left arm ended up being visible and all I could focus on was the excess weight in my upper arms.  I found myself looking away, at anywhere but there.  I tried to force my sleeve down to cover up that body part.  I was so relieved when he came back to rescue me from myself.

Later on I was at home working in my closet.  I finally decided to put away some of the clothes that don't fit me any longer after I became very frustrated with what I was going to take on my vacation tomorrow.  Barely anything in that closet fits.  I know that I am working on it and, hopefully, will continue losing weight but it's so frustrating to have to recycle the same five outfits over and over again.  I remember the big deal it was last year for me to give away boxes and boxes of my "fat" clothes.  Now I regret doing that.  Of course, at the time, I didn't think I'd ever be back here.  That is not to say I'm at my highest weight.  Any time I need a reminder of that, I can look on this very blog and see the number on the right side of the screen from MyFitnessPal that tells me how much lower I am than my highest weight.  Right now, that's 60 pounds and that definitely is a big deal.

So, I'm just trying the best I can to regroup.  I'm trying to ease up on myself and not be so self-critical.  I want to walk forward into my road trip tomorrow with a positive attitude.  I can let today go, knowing I don't need to treat myself so badly and knowing I'm a work in progress.  On a brighter note, I'm headed off with my mom to Vegas tomorrow.  It's usually a five-hour car trip from here.  My brother and his wife live there as well as my mom's cousin and her husband.  On the other side of my family, my dad will be there with my stepmom from Utah and my stepbrother, his wife and my little niece are coming in as well from Portland.  I'm splitting my time between my mom's side of the family and then my dad's side.  It's great, though, that we'll all be in town together.  As crazy as my family makes me at times, I love them and am looking forward to spending time with them.  I have decided that I'm not going to tell my dad about the gastric bypass yet.  That conversation is not going to happen with him until I'm much closer to a surgery date.  I have a long time between now and then so I'll just take it one step at a time.  Off to pack my bag!

Saturday, November 23, 2013

Scale vs. non-scale victories

For some reason, I woke up really early this morning.  I was still tired, but something made me get up.  I got on the scale to see how I was doing in the weight department.  If you'll recall, just two days ago, I weighed in at 368 when I did the bariatric surgery orientation.  This morning the scale said I was 361.2.  WTF?  In fact, almost five of those pounds were from yesterday alone.  I was thinking about what I did yesterday and what I had to eat.  There's no rational reason why I should have lost five pounds overnight.  I brought home a gift a student gave me, which were chocolates with macadamia nuts in the middle of each one.  And, yes, I did partake in them.  I actually convinced myself that maybe I was dreaming.  I eventually ended up going back to bed, weighed myself again when I woke up and the scale was even lower by a pound.  That's frustrating!  I always try to convince myself that the scale isn't accurate.  It actually is off by one pound, registering on the heavier side.  So I deduct that pound every time I weigh.  It's a relatively new scale and doctor's scales have confirmed that accuracy.

There is a lot of debate about how often people should weigh on the scale.  Some people say to do it once a day, once a week, even once a month.  The number can send some people off in a tailspin.  When I was doing Jenny Craig, they recommended weighing every day.  Their rationalization was, even though there would be daily fluctuations, it does tell you what direction you are headed in.  I have a friend that had the gastric bypass 12 years ago and she weighs every day.  For her, it lets her know if she's within her acceptable range or if she's crossed that magic number that says there's danger ahead.  When I've participated in my many diet attempts over the years, the majority recommended weighing in weekly.  I guess the reality is you do what works for you without making you obsessed about the number.  If I really search my soul for what works for me, I really believe weighing daily is what keeps me the most honest.  When I don't do that, I sometimes don't catch major weight gains until past the double-digit phase.  I am well aware that, as human beings and especially a female human being, there will be ups and downs. If I'm avoiding getting on the scale for fear of what it may say, that's me being dishonest.  I guess you have to do what
works for you.  Regardless, I'm glad it's going in the downward direction.

I also think it's very important to remember the non-scale victories as well.  The number on the scale is one thing, but it's not the only thing that tells me I'm going in the right direction.  I think of that the same I way I do as an holistic review of a college application.  I work in the counseling department of a high school and we often talk to the kids about how a good majority of colleges use a holistic review process to grant admission.  This means they look at the whole person, not just their GPA and test scores.  It's one thing to judge a person using just the numbers.  It's another thing to recognize the other facets that make them who they are.  In the same way, I am not just about the number on the scale.  I always need to remember that it's only a part of my process.  My self-worth does not come from that number.  Any time I start thinking that way, I need to catch myself, remind myself of all the good things about me and remember that I am a work in progress.  I want to be healthier and so that's what stepping on the scale is all about ... a tool in the process on the road to health.

Friday, November 22, 2013

Need to stay in the present moment

I confess that I have been feeling a wee bit obsessive about the gastric bypass surgery [stop laughing Z!].  Although I am able to concentrate on my work and take care of things that need to be taken care of, always in the back of my mind are thoughts about the procedure and my life afterwards.  I do have to give it props because it is a major decision and takes a whole lot of courage on my part, but I also need to be in the present day as well.  I have a lot going on that I have been procrastinating about and that's just not okay.  I received an e-mail from the graduate admissions counselor at Azusa Pacific today, gently reminding me that my deadline to submit my application for the Spring semester is about two months away.  Crap.  To my credit, I have started writing my personal essay and formulating what I will put in my vitae.  However, I do need to sign up for the certificate of clearance and taking the CBEST, let alone doing some refresher studying for it.  I also need to work on scholarships to help pay my tuition.  *Sigh.*

Something I am incredibly grateful for today, though, is that I have the next week off of work for the Thanksgiving break.  I can credit that to working in education ;-)  My mom and I are taking off to Vegas on Tuesday.  She'll be visiting part of her family and I will be visiting with family on my dad's side.  I'm looking forward to that time away and not doing any work during the week.  I have committed that to myself.  I always tend to do work during vacations and that sort of defeats the whole purpose.  On my way out of town, I will be meeting with a surgeon on Tuesday morning for a consultation.  I am quite certain everyone doesn't want me to go into the details here (trust me on that one), but I'm likely going to be having minor surgery based on the results of my recent colonoscopy.  So the surgeon needs to meet with me first, check out the area on my body that needs to be worked on and then probably schedule a surgery date.  How efficient of me for scheduling it on my way out of town.  In case you couldn't see it in my words on the screen, I was being sarcastic!  It's not exactly my idea of fun to meet with a surgeon right before heading out on a road trip, but being able to get an office visit so soon is sometimes incredibly difficult so you gotta do what you gotta do.

I'm glad to be able to relax a little bit and not think a lot about work or the things coming up in the next few months.  I will be taking my laptop with me so that I can work on my application for graduate school so I will be able to blog from the road.  Posting what is going on with me, especially the feelings that come along with activities and future surgery, is really important so that I can be honest about what I'm going through and process everything as I move along.  That's not even just about the surgery, but just my life in general.  The truth is that I don't want to go to food any more in life to have it help me deal with things that come up or used as some sort of crutch to keep me in a larger body. I definitely deserve better.

Thursday, November 21, 2013

My head is spinning

I had my orientation today to begin the weight loss surgery process.  When I got to the location of the class, I wondered if I would run into my old counselor from the Optifast program or if people at the front desk would judge me for having gained weight back.  I was actually feeling the nervous nellies when I walked in because of that.  I know it's all about me, not about them.  Of course everything was fine, as I'm sure it was going to be all along.  I got weighed in and my height was measured.  My weight today was 368.  Depressing.  Of course, I had just eaten and had been drinking water all day long so I'm sure that influenced the weight.  I haven't weighed myself in a bit.  I know that I reported my weight the other day, but that was from the last time I weighed.  However, I am here to be honest with myself so, o-freakin-kay, 368 it is.  Gulp.

The session had about 30 people in attendance.  I looked around at the other people, comparing my body to theirs and vice versa. Why?  I don't have a clue.  Maybe it was to convince myself that I was actually there.  Maybe it was to see if I was the worst one in the room.  The more I think about it, it was probably the latter.  In my mind, I convince myself often that there is no one worse than me.  I can say for sure that wasn't the case when I was in that room today.  There were several people, including women, who were larger.  There were a mix of people who were anxious to be there, to get started in this process, and others that I could tell were not very happy.  I get it, though.

I took copious notes, like the lifelong learner that I am, and wanted to document everything here.  It might be useful to others considering the surgery, but it's mostly for me to remember everything I'm going through and to explain the process to my friends (including all of you!) who read this blog.  Here are my steps, at least how I understand them to be today.

  1. Attend the orientation. 
  2. Complete a program questionnaire and return it to the director.
  3. Within a two-week time period, I will be approved to move forward with the surgery.  This does not mean I have final approval, but it means I can move forward with the process.  If, along the way, there become reasons why they deem I should not be approved, they will let me know.  However, they did say it is pretty rare for someone to be turned away after they are initially approved for reasons other than medical.
  4. Attend a Lifestyle & Weight Management class.
  5. Meet with the doctor overseeing the program to discuss my history, surgical options and have questions answered.  My weight at the meeting with the doctor will be my starting weight.  They want all patients to shoot for a pre-surgery weight loss of about 10% from this date.  Even patients who do not meet the 10% goal are not turned away, although they will have to meet with the doctor again.
  6. Fitness walk to determine whether or not I am ambulatory.  The walk is five laps around the parking lot of Kaiser's Positive Choice center.
  7. Begin the 6-month group educational classes.  The classes usually start about six weeks after attending the orientation (step 1).
  8. After finishing the classes, I then attend an orientation about six weeks later through Scripps Pacific Bariatric.  The surgery is not done through Kaiser itself.  They outsource to Scripps Mercy Hospital's Pacific Bariatric Center.  They are supposed to be excellent at the work they do and focus solely on weight loss surgeries.  This orientation is also an opportunity for family/friends to attend with me to learn more about the process.
  9. Meet with the bariatric surgeon, internist and one other doctor (can't remember the specialty at the moment and, of course, I didn't write that one down!).
  10. Go through a series of tests.  Actually, I will have lab work done throughout the process, I believe on a monthly basis.  
  11. Have the surgery.  The entire process, from the time I attend the orientation until I have the surgery is about nine months, although I can have the surgery up to a year after I complete the 6-month classes.
Some of the interesting facts that I learned today were the difference between the three surgeries.  The gastric bypass is considered the gold standard of weight loss surgeries, the creme de la creme, the mother load.  People who are diabetic and have the bypass most of the time go into remission.  The gastric sleeve used to be an interim procedure, something that was temporary for patients before moving on to the bypass.  In terms of the lapband, there have been real problems.  The program director was sharing with us that, of the last 34 lapband-related procedures Pacific Bariatric has performed, 33 were to remove the lapband because of problems patients were having before performing either the bypass or sleeve.  That's pretty significant.

In terms of the surgery itself, 95% of the patients are able to have laproscopic procedures.  This means that, instead of having a surgery where the chest is opened from the breastplate down to almost the waist, five small incisions are done.  This increases healing time and leads to less complications.  The director shared that most patients are not in pain from the surgery; they just feel uncomfortable.  For those that work in an office and don't have highly physical jobs, some can return to work in 1-2 weeks.  It just depends on each person and how well they do at preparing before the surgery and following the "rules" after the surgery.

In terms of the cost, this surgery is $50,000.  Whoa.  However, if you go through all the steps and have Kaiser insurance, you are only responsible for your co-pay.  For me, that is $5 for medications and $10 for all visits or hospital stays.  Here are all the things that have to be paid for:
  • Lab work to enter the Options program
  • Medical appointment to enter the Options program
  • Lab work prior to bariatric surgery referral
  • Medical appointment prior to bariatric surgery referral (only needed if 10% goal weight not met)
  • Psychological assessment at Pacific Bariatric Surgical Medical Group
  • Internal medicine assessment at PBSMG
  • Bariatric surgical consult at PBSMG
  • Hospital and surgical costs
  • Post-surgical consult(s) with bariatric surgeon at PBSMG
  • Medications prescribed by my bariatric surgeon
This is a LOT to process, isn't it?  Imagine what I was feeling!  Thankfully, after this appointment, I met with my therapist and talked about the entire process with her.  She told me that she could tell how confident and sure I am about this and I've clearly made a decision to move forward.  As we talked about everything, we discussed my next couple of appointments with her.  Here was part of our conversation:

"Kathy, we need to talk about how often you want to keep seeing me and what you will do when I'm gone." 

"Oh, are you going on vacation?"

"When I reti ... Wait a minute, you didn't know I'm retiring at the end of January?  I didn't tell you?"

"No, you didn't."

Dang it.  Just when I got into a groove with her, she's leaving!  I get the feeling she's going to talk to me
about phasing out of therapy and perhaps using it as needed.  I don't know that for sure, but that's the way the conversation went.  My feeling is that I am doing so much better than when I first started seeing her.  Yet, I am going to be going through major, life-altering surgery and there are bound to be emotions that come up not only going into the surgery but dealing with things after the surgery is over.  However, I decided that, instead of getting myself all worked up and worried about what will be coming up, I can just take it one step at a time.  I can breathe, in and out, and just put one foot in front of the other, handling the next indicated thing and nothing more past that.  Otherwise, I could get myself worried and projecting too much.  I don't need to put any added stress onto my shoulders, that's for sure.