Thursday, July 31, 2014

Consultations are now scheduled

Well, it looks like things are really moving forward now!  I received my authorizations today from Kaiser for the gastric bypass consultations, so I immediately called to schedule those appointments.  I was hoping to get them all done before I return to work on August 11th.  With two months off during the summer, it would probably not be great to turn around and take another day off.  Thankfully they were able to get me right in this coming Tuesday.  Hooray!  I will be meeting with a psychiatrist, internist and the surgeon with appointments one right after the other.  While all the surgeons are fantastic, I did specifically request the one I wanted.  I just have heard exceptional things about him and already met him at one of the information sessions.  I have prayed about this and God guides me at every turn.  I just felt that now is my time to ask for what I want.  So here I go!!

Having started this process back in early November, it seriously has felt like this time would never come.  Of course I knew it would eventually, but it feels pretty surreal.  After I meet with the surgeon, it will be a pretty quick turn-around to then schedule the surgery date.  One of my classmates, who has already completed her consultations, got her surgery date scheduled about a week from when she met with the surgeon (we have the same one).  I can imagine my experience will probably be just as quick.  Her date is almost three weeks away, so I'm guessing I'll probably have my surgery around the end of August.  Eeek!

I must admit I'm a little nervous, but I've been really trying to stay in the day about all of this.  The mindfulness class I am participating in, as well as the meditations I am doing at home daily, is really helping me stay focused.  If I project into the future, then I'm not honoring my process and, trust me, this is definitely a process.  When I do have those moments of thinking about the actual surgery and how very different things are going to be for the rest of my life, I start to feel anxiety.  Using the mindfulness techniques, I can stop and take those deep breaths to help bring me back to the present moment.  I know my mind with continue drifting to that day in the operating room, but I also know I have tools to help me with that.  Thankfully it is not my first experience with having a surgery, so I at least know what to expect in terms of that piece.  I'm grateful that I will be returning to work while I wait for the surgery date and the days leading up to that time - it will help me to stay focused on something else.  Of course, as I have more updates, I'll post them on here.  Thank you all for your continued support ;-)

Monday, July 28, 2014

Thinking about that spot and lab results

Today I went out to lunch and to a movie with a dear friend [hi sweetie!].  We had originally planned to go to the zoo today but it's been both hot and humid here so we decided air conditioning was a better option.  I love spending time with girlfriends because we get the opportunity to talk, whether serious or not so much, and just laughing.  We went and saw that new movie, Sex Tape, with Cameron Diaz and Jason Seigel.  We wanted something funny and it definitely delivered.  As we were getting our tickets to go inside, the guy at the box office asked me which movie and I told him, in a normal-level voice, "Sex Tape."  Apparently he didn't hear me, so he asked me to repeat it and I said, with emphasis, "SEX TAPE!"  I felt like I was announcing it to everyone in line.  I know I especially appreciate humor because things can be all too serious a lot of the time.  This past week for me is a perfect representation of that.

As I wrote about in my last post, my primary care doctor found a new, dark mole on my foot.  I will need to have another biopsy done on that, but I can't get in to see my dermatologist until next Monday.  This will be my eighth biopsy, I believe.  I know the drill by now ... the doctor does an inspection to determine necessity, injects Lidocaine to numb the area, shaves off the mole and then my body goes into recovery with a treatment of ointment and bandages for a week or two.  The results usually come in the mail, except for the phone call I received telling me I had cancer.  When I had cancer, that mole was bleeding and painful, but all the others have not been.  They have all been precautionary measures taken to ensure I was still in remission.  However, this mole I'm dealing with now feels different.  It's not big by any means, but it's new, it's dark and the area it's on hurts.  There's also another layer to this, actually two.

First, I'm on the road to bariatric surgery and so if this is something serious, that all will have to be put on hold.  Of course I know how almost shallow that thinking is.  I don't know, maybe it is, maybe it's not.  Choosing to have this surgery was extremely difficult and has taken the greater part of a year to prepare for.  I have had to wrap my brain around the fact that, after the surgery, my body will forever be altered and my relationship with food will completely change.  I have already arranged for the time off of work and a substitute is lined up at my high school.   My next step in the process is to receive the authorization to call and make the consultation appointments, which should be coming in any day now.  To have all of this put on hold is something that obviously I would do if necessary, but it also messes with my head at the same time.

Second, the mole is on my foot.  As a diabetic, I have always been taught by my doctor and all the research I have done that I should avoid getting cuts on my feet in case they do not heal properly.  If that is the case, it is possible to lose my foot to amputation.  By having the biopsy done, I'm deliberately having my foot cut.  If the cancer has returned, that means I will need surgery on my foot.  When I had melanoma, the surgeon cut into my back from the bottom of my shoulder blade almost down to my waist.  What would that mean for my foot?

I know you're reading this and probably saying something to yourself like, "Kathy, don't worry about it.  You're projecting into the future.  You just need to relax about it."

I know that is what I should be doing, but it's hard not to think about cancer because I already had it.  I am a faithful person and have a strong relationship with God.  I know He will give me the strength to deal with whatever is in front of me, but I'm scared.  I'm a human being and I'm scared because, like I said earlier, this one feels different.  I am praying for help through this fear and to take things one day at a time.  For the most part, I'm not thinking about it all the time.  There have been a couple of times, though, that I became overwhelmed when the "what if" thoughts entered my head.  Yesterday, for example, I was working out at home and became upset.  I don't know what set me off but I ended up on my knees in tears.  In the moment, I let myself cry and I prayed for help to get me through the difficult emotions I am experiencing.  There's no right or wrong to the feelings I am having.  I pray everything will be fine, but I also have to honor how I'm feeling, otherwise I'll eat over it.  I am writing about it here and talking to friends, which is an important part of my process.

To top off these emotions, I had some lab results come back from when I had blood work done for the surgeon.  Most of my lab results were fabulous - my cholesterol is fantastic, blood count is great.  One of the results, though, shows a high uric acid count.  This typically is an indicator of gout.  My mother and brother both have gout, so I immediately sent a message to my doctor.  I have some symptoms and, coupled with the family history and high uric acid count, my doctor wants me to come in to see her so that I can be tested.  Of course this can be treated, but it just felt like one more thing being piled on.  So next Monday, I will be seeing her in the morning to test for gout and then seeing my dermatologist in the afternoon to have my foot biopsied.

I know that we all have challenges in our lives, some lesser or more significant than others.  For me, it just feels like a lot right now.  I have chronic pain in my left leg and back every waking moment, diabetes, depression, sleep apnea, high blood pressure and I take a lot of medication.  I'm dealing with another biopsy and bariatric surgery to come within the next month or two.  There's too much stuff on my plate.  Seriously.  Seriously. Yet, I am reminded that I'm a blessed person.  In the moments of physical or emotional pain, I think I forget that.  I have wonderful friends and family that will hold my hand through anything, who love me for just being me.  Although I have pain in my body, I can still walk, I can still breathe on my own and I have a lovely roof over my head.  I am choosing to deal with all of the things I have written about today, even if the emotions have led me to tears.  I know God has a wonderful plan for me, even if I don't know what that is right now.

Okay, there, I feel better now.

Tuesday, July 22, 2014

Practicing mindfulness, fitness test and a new spot

I'm not doing great on posting more often.  I need to work on that because it is always so therapeutic when I do writing.  Since last I posted, I have been practicing mindfulness meditations as I mentioned in my last post.  It's amazing how peaceful and in tune with myself I have become just in this short time doing it (mostly) every day.  The guided meditations really help my mind stay focused.  For those that have Kaiser and want to take the workshop, you just need to participate in an intake appointment through the psychiatry department and then you can request the mindfulness group.  I am going through the list of online guided meditations and posting them on the resources page of my blog as I find some that are worthwhile.  I have found some really fantastic ones.  If you'd like to check them out for yourself, click here to go directly to the page with the list.  I love the "Self-Compassion" ones so far.  The speaker has a soothing, kind voice and I feel so relaxed when I am participating in the exercise.  Feeling peaceful with less anxiety is so amazing and, remarkably, doesn't take that long at all.  I even recorded some meditations in my own voice, following a script we were given in class, on my iPhone using the voice memo feature.  When it's time to meditate, I simply use my earplugs, sit in my meditation spot and within seconds, I'm feeling a lot of peace.  I thought it would be hard for me to meditate using some of the practices because I am not Buddhist, but I have found it works for any religion.  I don't need to lose my Christian roots and beliefs to enjoy the practice.  In fact, if anything, it enhances my spiritual center.

On Thursday, I completed my fitness test.  This was the next step in the process leading towards bariatric surgery.  Given that I normally walk much further on a regular basis than was required in the fitness test, I found it to be probably the easiest part of this journey.  It took about 5-7 minutes, that's all.  So now I am waiting for Positive Choice nurses to put orders in for lab work.  In talking to fellow classmates, they will be running 17 different tests so I'm sure they'll be taking plenty of samples from me.  Almost everyone in my pre-op classes are moving forward with surgery, so it's been great to see them posting their status in our Facebook group as they complete their next tact.

I had a routine diabetic follow-up appointment with my primary care doctor this morning.  She is incredibly supportive of my journey towards surgery and told me she was proud of me for not only making this decision but also hanging in there through the classes I was required to take.  She agrees that the gastric bypass (versus the sleeve) is the better choice for me for long-term success, even if I didn't have diabetes.  I was glancing at the computer screen while she was doing some typing and it has me classified as super morbidly obese.  If I ever forget my bottom line, I must remember that because the decision to move forward with surgery has been completely about quality of life.  Of course I can't wait to wear cute clothes, but my health is the most important.  I did tell her I have a little concern about the malabsportion issues and she shared some interesting info about that in terms of complications.  She's been a doctor with Kaiser for over 25 years and she said that ever since they started doing the bypass laprascopically, they have less incidents of complications and dumping.  She has found that curious because they haven't changed anything with the surgery internally, but doing it that way versus an open surgery has produced better results in terms of fewer complications.  While I was in with her, we were looking at my blood sugar numbers and she did a foot exam.  The foot exam is something all diabetics should do to make sure they don't have cuts on their feet that they're not feeling.  As she was looking at my feet, she asked me how long I've had the mole on my left big toe.  My response to her was, "Are you sure it's not just nail polish?"  I had just painted my toes dark blue the other day so I thought maybe I somehow got some there (it's under my toe near the top, so it's hard to see).  She looked at it closely and she confirmed that it was, in fact, a mole.  I did have a body scan when I went to see my dermatologist a few weeks ago, but we didn't check my feet if I remember correctly.  When I came home today, I checked it more closely and it definitely is a mole.  My doctor is very concerned.  She's the one that spotted my first mole that turned into melanoma three years ago so, of course, that concerned me, too.  She has sent a message over to my dermatologist's office so that we can book an appointment.  I feel biopsy number eight coming on.  I'd rather be safe than sorry, so I will definitely do whatever I need.

I see now why the mindfulness meditations are more timely than ever before.  Finding peace in the middle of anxiety, whether it be about the surgery or the biopsy, is incredibly important for me.  Practice mindfulness folks, it really does make a difference.  Maybe it won't change the outcome of situations, but it does change how I choose to deal with it.

Tuesday, July 15, 2014

The idea of mindfulness

Today I had a group appointment my therapist scheduled for me and I didn't know what it was for as I walked in.  She had suggested a couple of Kaiser groups I could get involved with since I have been feeling anxious about the upcoming gastric bypass, especially since my pre-op classes ended last week.  I thought that was a great idea, so I told her I was pretty much up for whatever she suggested.  After checking in, I was led, along with about eight other people, into a dimly lit room with chairs in a circle and a bright white candle in the middle on the ground.  It was very soothing, but quite inviting.  The facilitator explained this group was about mindfulness.  I'd like to share a little background on this, explained by the therapist in a much better way than I can:

Mindfulness is a way to pay attention, without judgement, to what is going on in each moment with a a stance of curiosity and compassion.  It is a state of being present in the here and now; being in the moment, being in your body; not being on autopilot.  This sounds simple, but with all the things competing for our attention, being still and quieting the mind, body, and spirit can seem almost impossible.  Creating stillness, calmness, and peace within, is an art to be cultivated and the practice of mindfulness provides the mentoring and guidance to settle down.  When you are creating healthy habits in your life and letting go of those that no longer serve you, Mindfulness is a beautiful way to guide you along your journey.  It is like having a gentle coach instructing you how to achieve your fullest potential with love and compassion.  Mindfulness can do all of the following:
  • Reduce stress
  • Improve immune function
  • Enhance appreciation and gratitude
  • Greater acceptance of self and others
  • Improve positive decision making
  • Calm the mind
  • Improve focus and concentration
  • Help manage physical and emotional pain
  • Create inner peace and feelings of joy
  • Reduce reactivity and help us control our responses
  • Retrain the brain to think more positively
  • Decrease anxiety and depression
  • Improve disordered eating habits
As you can imagine, if you've been reading my blog for any period of time, I was glad I was attending this group.  We started out by each one of us saying something we are grateful for right here, now, today.  Then the first exercise was to get us centered and focused on our breathing.  After doing that for a few minutes, we had some discussion then went into a second exercise.  This one was about total body relaxation and letting go.  I closed my eyes as the therapist guided us through an absolutely phenomenal experience.  She had us focus on parts of our bodies and move them or feel them mentally ... feel your feet planted on the floor in your shoes and now wiggle your toes, feel the bones in your ankles and how they support your legs, on up until we reached our heads.  She then had us take the parts of our bodies that were full of tension or pain and let that tension and pain go in our minds while we focused on the in and out breathing of our bodies.  As we continued to listen to her instruction and focused on our breathing, she had us each think about someone we wanted to offer compassion and think positive thoughts for them.  We thought about their happiness, peace and love.  Then she turned it around and told us to now take those feelings of compassion and bring them back inward toward ourselves, without judgement, but pure love, just as we would extend for another human being.  

An amazing thing happened for me ... as we were breathing and focusing on relaxation and the release of anxiety, stress or whatever ails us, I couldn't feel the chronic physical pain that I live with every day in my back and left leg.  While I was doing the mindfulness exercises and my focus was on peace, it was as if the pain left me.  That does not mean it went away, but my mind was not centered on it as it usually is.  I really did feel peace, even when it came to compassion towards myself.  

I absolutely loved the experience of this mindful meditation.  I can go every week if I so choose and I have decided that I will do precisely that, especially leading up to my surgery.  She gave us handouts, some even with scripts, to practice during the week.  The goal is to do it for a few minutes each day and I'm definitely going to do that.  The feeling of peace and being centered was really incredible and I hope to get to a point where I can find that more often through these exercises.

I find it ironic that my decision to pursue bariatric surgery has given me so many wonderful benefits.  Obviously it's leading towards better physical health, but also emotional and spiritual health as well.  My pre-op classes focused a bit on the surgery and how to eat before and afterwards, but they spent more time on other issues such as self-esteem, courage, healing and so much more.  I met some wonderful people that have become dear friends in the process.  I feel like the path I'm on is the right one for me.  It feels deep all around and I like that.

Monday, July 14, 2014

Taking this time for myself

Approaching the start of this summer, I knew I wasn't going to pursue much work while I was on vacation from my job at the high school.  I thought about it since I don't earn a salary during the summer break, but I also knew that I would need to give myself time to go to all of the medical appointments leading up to the surgery.

The pre-op classes ended last week and so I'm focused on things coming up.  Within the next several weeks, I have about ten various appointments and that doesn't even include meeting with the Pacific Bariatric psychiatrist, internist and surgeon.  I'm continuing to see my therapist, meeting with the sleep specialist, I've got the fit test on Thursday and so much more.

Like a lot of people I know, I have a tendency to take care of other people before myself.  Well, now is finally the time - just like the name of my blog suggests.  Now is the time to put my health first.  Now is the time that I focus on what my needs are as I walk forward into major surgery.

I've spent some time this summer (so far) with friends, but I've also spent some time alone, too.  It's okay to be alone.  I always associated being alone with being in a depressive state, at least for me.  In the past, I chose to be alone because I was isolating.  Now I am choosing some time by myself because I am embarking on a huge change in my life, one that will impact me for the rest of my life.

Having the surgery is not a decision I take lightly at all.  I don't joke about it and I have given it serious consideration at every turn.  Part of my alone time has been focused on talking and praying to God, getting back into His Word.  I am strengthening my faith as I move forward and I know I will continue to do so as I move closer to the day when the operation will take place.

In the meantime, I am also appreciating time with friends and family, remembering what an amazing support system I have in them.  I know I have incredible support online as well.  I have met some pretty terrific people through this blog, Twitter, MyFitnessPal and Instagram.  Sharing my story with other people reminds me that while this world is big, other people travel the same roads I do and if they can do it, so can I.  I'm taking these days one at a time and putting one foot in front of the other.  I'm remembering to stop and breathe through the fear and excitement I feel.  Breathe, Kathy, breathe.

Friday, July 11, 2014

Seriously, don't do what I did

I don't like using the word stupid.  It's a mean word, especially for those in this world that have been called that in their life.  However, I have no other word to use to describe what I did today.  It really was stupid. It was stupid squared.

Last night, I decided to go to bed late and took Ambien before falling asleep so that I could do so using my CPAP machine.  I'm still struggling being able to sleep with that darn thing.  I haven't given up on it, though.  I actually called the doctor, who's a sleep specialist, for help today.  I knew, though, that it would probably make me wake up later, which it did.  I did manage to get a few hours on the machine though.  Yay for that.  Because I woke up later, I was pretty hungry so I had a protein shake right away.  I've been trying to replace 1-2 of my meals with protein shakes in preparation for surgery and to continue to lose weight leading up to the surgery.  I then decided to run some errands.  While I was out, I was a good distance away from home and was ready for lunch.  If I waited until I got home, it would have been about 3 p.m. before I had anything to eat so I decided to stop somewhere for food.  And where did I stop, you're wondering?  Well, of course the healthiest place I could go ... Panda Express.

I told you, stupid decision.  I love Chinese food and, really, this isn't really good stuff, it's just fast and convenient food that I guess could pass for Chinese for the less discerning out there.  What I ordered was fried, coated with sugar in the form of sauce and a carbohydrate lover's dream.  I can't even tell you what my thought process was while doing this to be quite honest.  Maybe it's because my food has been super clean and I felt like I needed a "reward".  Maybe it's because I'm having surgery in a month or two and I'm feeling like I need to eat it while I can.  I just don't know, but it was a horrible decision on my part.

As soon as I got home, I wasn't feeling very good.  Ya think?  My tummy is not used to this stuff anymore.  I kind of felt sick to my stomach.  I also could feel my body reacting and knew my blood sugar was probably elevated.  That's a freaking understatement.

I did a double-take when I saw that number and went into a little bit of a panic.  Then I immediately went into my fridge and pulled my insulin out to inject into my body to bring that number down.  After eating, it should be around 140-160 at the most.  I knew I needed to continue bringing it down so I worked out hard when it was safe to do so (you shouldn't exercise when it's too high).  I was dripping with sweat, somehow trying to negate what I did.

After that, I logged everything into MyFitnessPal so that I could keep myself honest.

That lunch alone was 1,350 calories.  If I had the entire serving of chow mein noodles, it would have been even worse.  These are the moments that I get reminded why I am pursuing weight loss surgery.  Clearly I'm going to have to continue changing my relationship around food since surgery is just a tool.  It is not going to fix the part in my head that gravitates towards certain foods or overeating.   The only thing it will do will prevent me from having large quantities of food in one sitting. I'm keeping it real here, though, because we're as sick as our secrets.  Was it worth it?  Absolutely not.  I pray I remember how I felt today the next time I feel obligated to indulge. Panda Express ... are you serious Kathy??

Monday, July 7, 2014

Finished my pre-op classes and weekly-weigh in

After complaining about how long the classes were going to be, tonight I finished the six months of pre-op classes required through Kaiser to move forward with bariatric surgery.  I can still remember the time, years ago, when I was talking to a friend at work about wanting to do the surgery but just not having time to wait for classes.  When I think back on it, she was so patient with me.  She had gastric bypass herself a long time ago and I confided in her that I wanted to pursue surgery but I wasn't willing to wait to take classes.  Unless a person chooses to pay out of pocket and go down to Mexico for surgery, it is a very long process.  In fact, I'm still not done with mine.

In terms of my ending weight, the program doctor wants you to lose ten percent of your body weight by the end of the classes or to at least be ten pounds away from that goal.  I weighed in tonight and was so disappointed because I was half a pound from reaching that goal.  Can you believe it?  Half a freaking pound!  I told my classmate sitting next to me and she told me to go to the bathroom and poop.  Ha ha, I busted out laughing.  I raised my hand and asked my facilitator if half a pound would be okay.  Sure, I could have lied since she doesn't check our weight on the scale.  If we haven't met the goal, we would have to go back to the program doctor to be reevaluated.  This could take up to an additional three weeks and he could have told me to work on it longer or even outright denied me.  Of course, we were assured that this never happens.  Anyway, when I asked if that half a pound would be okay, she and the entire class told me to go out, use the bathroom and take off whatever I needed to take off to ensure I would meet that half pound.  They all were completely serious and waited until I left the room to keep talking.  I went down the hall and used the restroom.  I did have a lot of water to drink today, especially before class so it was possible.  When I got back to the scale, which was in a separate but adjoining room, I took off my shoes and even took off my Fitbit.  I seriously considered taking off my top for a second or two, but someone could have walked in on me.  Honestly, I would have stripped down to the bare essentials if I knew no one would walk in from one of the other classes.  However, I'm happy to report that between my visit to the restroom and the removal of what I could take off, I made the weight requirement with a half pound to spare. Yahoooooo!  I swear, I was never happier to see a two pound loss this week than ever before.

Now the next step is for our facilitator to submit our files back to the program director and then she will process them.  That could take up to two weeks, but generally it happens quicker.  Then I will be required to complete a fitness test.  That consists of walking around this building five times.  It's not a very big building at all and, given that I aim to walk 10,000 steps a day as much as possible, that shouldn't be a problem for me.  That is about five miles a day so I'm not particularly worried about that test.  In the meantime, as one of the surgeons has recommended, I am trying to replace one to two of my meals with protein shakes.  Since I'm lactose intolerant, I have to be pretty selective with what I choose to drink.  I've been using Muscle Milk but it doesn't have enough protein in it so I ordered from Bariatric Advantage.  It's the brand that Kaiser recommends and I do get a discount since I'm a member.  It's pricier but if its better for me, I'm in support of that.  All of this shake drinking reminds me of being on Optifast again in some ways.  There is a huge difference, though - I felt very weak and lightheaded when I was doing the Optifast shakes.  I don't feel that way at all using the protein replacement, as long as I get enough of it in.  The smaller I can get for surgery, the better it is for the actual procedure.  I'm excited to continue moving forward.

Sunday, July 6, 2014

It really was a miracle

Somehow, in the middle of my frustration and tears about not being able to sleep, came a grace from God that is unexplainable to me.  Miracles happen every day, some large and others small.  My small miracle (although I consider it to be huge) is that I was able to finally fall asleep on the CPAP.  I really don't know how it happened, other than my complete surrender and humility to ask God for the help I was desperate to receive.  When I went to bed last night, I prayed a lot and, I admit, cried a lot.  Frustration and sheer exhaustion will do that to a person. FYI, it's hard to gracefully cry with a nasal pillow on your face ;-) Sleep didn't occur right away.  In fact, it took several hours to happen, but eventually I did fall asleep with the machine.  The gratitude I felt this morning when I woke up practically brought me down to my knees.  It is a miracle ... I have been trying for months and months to sleep with the mask.  Only after a deep surrender did it happen.

After I woke up this morning and had my breakfast, I decided to go for a walk by myself at the beach.  Of course, being "by myself" on a Southern California beach in the summer is impossible, but no one was able to go with me and so I went alone.  I was able to tune out the other people around me and just focus on what I was there to do.  Check out what I experienced.

It was a perfect day.  I felt a lot of peace and that was reflected in my food choices.  I've been having protein drinks to replace some of my meals since I'm getting closer to surgery, but I have not felt deprived nor am I going in the kitchen looking for food to eat.  There's just a lot of simplicity there without feeling deprived.

Tomorrow is the last day of my six months of pre-op classes.  While I'm glad to be done with this part of the process, it is a bittersweet step at the same time.  I've become good friends with my classmates and I'll miss seeing them every week, as well as our leader.  We have decided to continue meeting, though, to support each other as we go through this process.  We probably won't meet every week like we do now, but I'm sure it'll be 1-2 times each month.  In the next several weeks, a lot will be happening in terms of getting closer to a surgery date.  It's not something I need to fear, though.  God is with me every step of the way in my life as long as I invite Him in.

Saturday, July 5, 2014

In a fight with the mask and it's winning

I am exhausted.  I mean, beyond tired.  I have been trying, desperately I might add, to sleep with the CPAP machine.  I have been doing things like just sitting reading or watching TV with it on me.  I have tried to fall asleep in every position possible.  I have been trying to meditate before bed to put myself in a zen-like state.  I have been using the ramp feature to slowly ease the pressure going into my nose.  It fits perfectly on me and I breathe just fine with it on.  Even though I have been taking a very strong sleep pill (Ambien), I still can't sleep.  I tried again today when I attempted to take a nap.  In frustration, I started to cry.  I don't understand what is wrong that I can't sleep with it.  Is this really a psychological issue or is there something physical going on?  I'm trying not to overthink it but how can I not when sleep is eluding me every single time?  Right now, I just don't know what to do.  Anytime I tell someone, they come back with, "Well, did you try x, y or z?"  Of course I have!  Every freaking suggestion that someone has I have already tried.  They ask questions as if I haven't really been trying.  I have.  I'm not giving up on it because, after all, what's the alternative?  I just can't impart sufficiently how difficult it is to function without enough sleep, or any sleep for that matter.  I'm starting to worry that this will prevent me from getting the surgery because of the stomach blowing apart issue when air is put into my body.  I guess I just needed to vent my frustrations.  I want to try very hard not to pull off the mask tonight.  I do that when I've been laying there for hours and hours, knowing that if I pull it off I'll at least get some sort of sleep.  If you are able to get a full night of sleep, consider yourself blessed.  I need to remember that with God all things are possible.

Friday, July 4, 2014

Alright, I'm feeling anxious

On Tuesday, I had an appointment with my therapist.  Right now I have been seeing her every 3-4 weeks or so.  We talked a lot about what I can only describe as anxiousness with the surgery coming up.  When I think about what's going to happen inside of me, I get nervous.  Of course the gastric bypass is a much more invasive surgery  but I think I would still feel the same way with the vertical sleeve since they cut out a portion of your stomach and actually remove it from your body.  Either way, it's major surgery.  I am not rethinking having the surgery.  I am definitely going to have it, but I am just feeling all of these emotions around it.  Part of me is saying, "Look at what you have to do in order to lose weight ... you did this to yourself."  The other part of me says, "What if, after all the work the surgeon does, you still don't lose weight or manage to put more on?"  I am not trying to be negative, but I guess it's just fear that I'm feeling.  This scares me in some ways and excites me in others.

Another thing the therapist and I talked about is my fear of heights.  I know I've described it here before, but it feels like it has gotten worse over time.  We delved into that a little more and I discovered that, for me, it's not necessarily about the height but the fear of falling.  I have been associating these things with my weight.  When I get on a bridge, I wonder if it can support my body, never mind that cars drive on bridges or other people are walking there, too.  It's completely not rational to think this way, but it ties into my body image.  My therapist feelings I have anxiety going on, which I do agree with.  She told me she'd like to see me every two weeks leading up to surgery.  I'm glad she suggested that because I actually was going to ask to see her more.

On Wednesday, I went to listen to another talk given by one of our surgeons at Pacific Bariatric.  It was given by another surgeon, so it was a different perspective.  He discussed some of the same things and some different things than the previous surgeon.  One of the things he said absolutely freaked me out in regards to patients who have sleep apnea and are on CPAP machines.  He said that we must use the machine for at least two months prior to surgery.  If I don't wake up from surgery, the machine will do the breathing for me.  However, if I'm not regulated with the use of air and the air from the surgery goes into my stomach, it can actually blow my stomach apart.

I have been struggling to sleep on that darn CPAP.  The sleep specialist had prescribed me with Ambien to help me sleep.  When I take it without the machine, I'm out.  When I take it and then put on the CPAP, I can never fall asleep, so I end up very groggy with no sleep.  My problem is that when I try to sleep on my back or side, I will start to fall asleep and then I wake up.  I don't know if it's because I stop breathing or start snoring.  The doctor has told me that the pressure on my machine should prevent that from happening and there are no adjustments he can do that will make things any different.  In fact, he has told me he believes it to be psychological.  Up to that point, I felt it was completely a physical issue - I can't fall asleep with the machine, end of story.  I never considered that it would be an emotional response to the machine.  I do have an appointment with the sleep specialist, but it's not until late September and I can't get one any sooner.

The other night, I decided to give the machine a go again, to no avail.  I was almost in tears because I was tired and so desperately want to be able to sleep with the machine.  I don't have a problem wearing the mask.  Occasionally I will have to adjust the positioning, but I'm fine with breathing as it lays on my face.  Yesterday I decided to call my psychiatrist.  I have a psychiatrist?  Yes, I do and there's absolutely no shame behind that for me.  I went to see her a year or so ago because I was going through what turned out to be a clinical depression.  That was when I started therapy as well.  After everything I have been through in the last several years, let alone other years, I needed to ask for help.  That's something that is very difficult for me to do but I knew I needed it.  When I made the call to her yesterday, I described what was going on between the CPAP machine and the anxiousness around the surgery, wanting to see if there's anything she can do or prescribe to help me through this.  It's very difficult being tired all the time.  The reason I take as many naps as I do is because I can't sleep very well at night.  I'm waiting to hear back from her to see how I can move forward.    I tried the machine again last night and had the same results so, after trying for several hours, I finally took it off so that I could at least get some sleep.  I know the best thing I can do is to take things one day at a time.  My mind has already gone to the thought, "If I can't fall asleep with the machine, does that mean I won't be able to get surgery?"  This is precisely why I have to take things one day at a time instead of projecting into the future.