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??

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.

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.

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.

Pre-op class #14 and weekly weigh-in

This week's pre-op class was about identifying the choices I make on a daily basis and being able to accept responsibility for outcomes.  I realized how proactive I have been about making small changes since the six-month classes started to help me be as successful as possible when it comes time to have my vertical sleeve done.  Little by little I have been doing more and more very positive things, such as logging in all of my food, getting in regular exercise and starting to practice post-surgery eating behaviors like getting my protein in first.   I don't want to be in a situation where I am scrambling to start adopting certain post-surgical habits.  Instead, I would really like to just focus on healing and making healthy choices for myself.

During the class, a question was posed about some choices I regularly make that I dislike and cause me discomfort and pain.  The two things that came to mind right away for me was having to inject insulin because I am a diabetic and the pain I have in using my CPAP machine.  It really is hard to adequately explain how painful it is to be in a place where I need to inject insulin into my body to live.  It's not the physical pain of the needle so much as it is the emotional pain that surrounds it.  My body does not produce the insulin that naturally occurs in non-diabetics, so I have to put it into my system through a needle in my stomach.  If I don't do that, I could very well die.  There are so many emotions that surround that, running the gamut from frustration to fear.  In the same vain, the CPAP machine causes so many emotions as well.  Prolonged non-usage of the machine could lead to congestive heart failure, among other things.  It causes me emotional pain and physical pain.  I am having a very hard time sleeping with it on my face and the sleep medication I have been prescribed to take to help with that leaves me very groggy and unable to sleep with the machine on my face.

Those two things cause me a lot of distress and bring about a myriad of different emotions.  I pray that after the surgery, these two major issues get resolved.  Only God knows what the outcome will be.  I know things will be better with continued weight loss, it's just a matter of continuing to practice resiliency as I walk through this process.  Speaking of weight loss, I lost four and a half pounds this week.  Wooo hooo!  I am super thrilled with that loss.  That brings me to a loss of over 23 pounds since I started the pre-op program.  While I'm in this phase, the surgeon wants us to strive for a ten percent weight loss prior to surgery.  I have about 14 pounds to go to hit that goal, so that feels really good.  In fact, I'm feeling really good in general about where things are for me right now.  I'm celebrating successes and also facing challenges as they pop up.  A day at a time, that is very manageable.

Water Challenge Day 87:  Drank 178 of 174 ounces

WLS decision made, sleeping after surgery

I'm a planner and always have been.  I don't like to leave too much open to chance when it comes to big decisions.  When I decided to buy my house, I did an incredible amount of research so that I wasn't make horrible choices that I would regret.  I talked with different lenders, looked at how interest rates would affect my bottom line every month and really looked at pros and cons before throwing my hat into the ring.  I have no problem being spontaneous about some things, but major life decisions for me are pretty serious.  So, when I decided that I was going to have weight loss surgery, it was something that I gave incredibly serious consideration.

After weighing pros and cons, doing a ton of research and talking to a lot of people who have already had the various surgeries, I have decided that I will definitely be pursuing the vertical sleeve and not the gastric bypass.  While I am keeping an open mind, it is just my preference at this point.  My body has been through a lot in it's 42 years, particularly in the last several.  Let me see if I can remember it all:

• Cancer that required surgery for two separate sites on my body
• Lost 192 pounds with Optifast and then gained a lot of it back
• Chronic pain syndrome with my legs
• Back pain
• Osteoarthritis in both my knees
• Tendinitis and carpel tunnel issues that required surgery in my right wrist, with continuing problems in both wrists
• Intestinal and digestive issues
• Type 2 diabetes
• Sleep apnea
• High cholesterol

Anyhoo, I'm sure I'm not remembering everything but suffice it to say it's a lot.  While I don't want to put my body through more, I feel that weight loss surgery is necessary for me to have a good quality life.  My attempts in other ways so far have been unsuccessful.  Given my choice between the two surgeries, I want to go with the less invasive one, especially when having to potentially deal with malabsorption issues.  If my surgeon told me he would not support the vertical sleeve and would only perform the gastric bypass on me, then of course I will reconsider.  However, given everything I have seen so far from my insurance company, the choice is really up to me (insurance covers either of these two surgeries). 

There is a certain sense of relief in having made the decision because I at least know what direction I will be going in.  One of the things that has been on my mind a lot lately is the sleeping issues I have.  I have shared a lot on this blog before about my issues with sleeping and the CPAP.  While it's a hit or miss for me right now, I'm continuing to use it.  When I can fall asleep with it, I have a wonderful state of feeling like Sleeping Beauty.  Yet, no matter what I do, I cannot sleep on my back or side with it.  I try and then my body wakes up.  I think it's from the obstruction of my airway in those positions.  I keep trying, though.  My sleep doctor has told me that my pressure is exactly where it should be based on the data from the machine, so he's not sure why I can't sleep in those positions.  

Instead of continuing to stress endlessly about whether or not my inability to sleep on my back or side will prevent me somehow from having the surgery, I decided to pose the question to the Facebook group I'm in for people who have had or are going to have the vertical sleeve.  I have asked the question before to gastric bypass group I was in (with not many responses), so I thought I'd try with sleevers since that is the surgery I will be doing and this particular group seems to be a lot more active.  Here's the feedback I received.

My original post:  I'm in the pre-op classes right now, but I have a question about the surgery.  I'm a tummy sleeper, cannot sleep on my back or side no matter how hard I try.  I do have a CPAP machine and even that is not helping.  So, if you have already had the surgery and sleep on your tummy, how did you manage with the surgery since the incisions are on the stomach?  I won't be able to see my surgeon until after I'm done with the classes so I'd just like to hear from others with the same experiences.  Thanks.

Responses (trying to keep the respondents confidential) ...

• I was sleeping on my stomach the first night.
• Had surgery 3/10 and sleep on my stomach.  The first week was rough but I am fine now.
• It took me about a month.  You will find yourself on your stomach one morning and not even know you did it.
• You just have to.  It sucks.  The first few nights you'll pretty much be out of it so it won't bother you.  But it is hard.  I slept in a recliner for part of the night for nights four and five.
• I had a friend that slept on her tummy in the hospital right after surgery.
• You'll be able to sleep.  I slept on my stomach from week out.
• I am having an easy time on my left side hugging a pillow.  I informed my husband today that we need to go buy me a body pillow.
• I waited about 2 weeks then went back to sleeping on my stomach.
• It took me a week.  I kinda leaned on my stomach.
• I slept in a recliner for the first two weeks, then I eased onto the bed.  I think a lot of it depends on how big you are/were when you have the surgery.  Also, where the doc puts the incisions  and how many you have.
• I slept just fine on my back.  I was really surprised that I could do it.
• I slept in a recliner for a couple of weeks.
• So far adjusting with pillows on my back or side are working for me  I also use a CPAP.
• It was only a week I couldn't sleep on my tummy.
• I also slept in a recliner.
• I slept in a recliner too.
• I didn't sleep in a recliner.  I slept in my bed and after a week or two was back to sleeping on my tummy.
• Slept on my side and hugged a pillow.
• I used a lot of pillows in the bed or slept some in the recliner ... after about a week I could sleep on my side and at about 2 weeks I could sleep on my stomach again ... didn't sleep very well until I could sleep on my stomach again.
• I slept in a recliner with pillow over my belly.
• I was outpatient.  I was home 2 hours after my surgery and slept on my stomach when I got home.  You will be fine.  Don't confine yourself to a chair ... give your bed a shot and try sleeping on your stomach.  It may not bother you ... it didn't bother me.  You will want your bed.  Trust me.
• I'm 4 weeks out and have been able to sleep on my stomach since week 2 ... for the first week it was on my back ... then I went side ... and then I used pillows to help me sleep on my stomach kinda ... and then advanced to my stomach.
• I had surgery wed and am side sleeping already.
• I sleep on my tummy, the first few nights after surgery I slept upright in a recliner though.
• Tried turning myself in recovery to side.  Once in room, turned on side and slept on side/tummy.  Way I normally sleep.  I cannot sleep in a recliner.  Too uncomfortable on back.
• I too am a tummy sleeper but I was SO MUCH more comfortable on my back ... the meds do that to you!  It becomes a challenge of trying to get comfy so I can assure you it will be easy just to sit back with extra pillows in bed and sleep!

I was incredibly grateful to receive such amazing responses.  It made me feel 100 percent better and immediately removed the worry I was having inside about how I would possibly sleep after surgery.  So now I continue to move forward on this.  I'm reading a really huge book that one of my fellow classmates in the Kaiser program lended to me on the sleeve surgery.  It's such a great source of information and helpful tips in how to be successful so I'm taking notes on it.  I'm feeling really good about my decision right now and am staying positive.  I've still got months and months to go before I can have any surgery, but it's good to know where I'm headed.

Day 62 of Water Challenge:  Drank 180 of 180 ounces

• 
  

Feel the burn

I did much better on my water today and got all 183 ounces in.  It's a lot, obviously.  I'm still working on the water challenge, which has been a great thing for me.  I'm not perfect at it by any means, but I especially do a happy dance when I get my daily goal in.  I feel like it's a homework assignment I have to finish before I can post on my blog.  I was reading in the Options class materials about what eating and drinking will be like after the gastric bypass surgery and it's nowhere near what I'm getting now.  However, for the little pouch I will be having for a stomach, a few ounces is a lot let alone eight glasses of water.  

I got up so refreshed this morning.  Being able to sleep with the CPAP machine now has been heavenly.  I always knew it was going to help me get good quality sleep, it was just a matter of figuring out how to sleep on it.  After I got up, I had a great breakfast, read a few blogs and then decided it was time to get my exercise on.  I've been trying to make sure I'm stretching and doing the exercises that my physical therapist gave me for my legs.  In my bedroom I spotted resistance bands and thought that would be an awesome way to stretch.  

Oh man, I forgot how much those lovely bands really work my muscles.  Right now as I type this, my biceps are screaming at me to stop moving.  That's just with typing this post ... can you imagine what real movement feels like?  I also have one of those weighted balls, six pounds, and exercised with that, too.  I have a feeling my arms are gonna be none-too-pleased with me tomorrow.  After all of that, I put on shoes and decided to go out for a walk to get in some cardio.

Where I live in Southern California, we haven't been having much of a winter.  Usually it gets down to the 30's and 40's overnight and heats up a little during the day.  Right now it's in the 80's during the day.  Yuck.  I'm not complaining since I know people are experiencing much worse, but it would be nice to have cool weather while walking outdoors.  I had intended on going three miles today but my legs were having no part of that.  With the knee and leg pain I have, I definitely have to listen when my body tells me not to push it.  When I try to ignore it, I have to pay painful consequences.  I ended up walking 2.2 miles.  The MapMyWalk app told me I burned 755 calories so I'll take that for sure.

Sometimes I get really frustrated with my limitations.  I just want to get out the door and run like I see so many people doing.  Even when I'm walking, I'd love to do it with no pain or at least a minimal amount of pain.  It sometimes makes it very difficult for me to want to exercise because even though I really want to do it internally, my body feels the results of years of being obese.  Oh how I pray that someday I will be free from the pain.  Many of us have challenges in our lives, that's for sure.  I'm extremely grateful that I have the ability to walk on my legs and that my heart lets me get this exercise in.  It's just hard when I'm in pain all the time.  This is another reason I have chosen to do the right thing for myself in pursuing weight loss surgery.  My health and a long life are so important.

Water Challenge Day 37:  Drank 183 of 183 ounces

Telling my parents about the surgery

Deciding to proceed with the gastric bypass surgery was a very difficult decision for me.  It's one thing to say, "Yeah, it's time for me to have the surgery," but it's quite another to actually move forward with it.  There are so many emotions to go through - Could I have tried another diet?  Is this really necessary?  Am I really so far gone that I actually need a surgery to lose the weight?  I go through so much with this, but then I forget how much it impacts other people.

I really learned that on the day I told my mom back in November.  She cried and I cried with her.  She was so very afraid that something bad was going to happen to me during the surgery or that maybe I wouldn't wake up after the surgery.

Then there is my dad.  The person I have stressed over and worried about the most when telling the news of the surgery is my dad.  Of course I'm an adult and of course I can make my own decisions regarding this.  It's just that I want my parents to be supportive.  Maybe we don't always see eye to eye on everything, but having their support is important. When I brought up the idea of having surgery 6-7 years ago, he was so adamant about me not doing it.

My dad is visiting me for a few days right now, so I decided it was the right time to tell him.  I wanted to tell him in person with none of the other family around, just a discussion between father and daughter.  I gathered up the courage and told him that I have decided to have the gastric bypass surgery done.  His response?

"That's fine, but you should just know that it only works for one in five people."

There you go.  The judgement I knew he would have was there.  He sat across from me with his arms crossed, an internal decision made.  So I asked him where he got his statistics from.  He went on to tell me about the friend that he knows that got the surgery that was unsuccessful.  This one person represented all people.  I asked if that person was compliant with the rules laid before him.  He admitted he had not been compliant.  Of course that person won't be successful if he's going to do it that way.  I asked what kind of research he has done and he admitted he hadn't done any.

I went on to have a conversation with my dad that was as full of as much courage as I could possibly possess.  I said, "Dad, you know I have struggled with weight my entire life.  You know I have tried so many different programs and diets.  You know how devastating it was for me after gaining weight back when I stopped doing Optifast.  My decision to have this surgery is about health, pure and simple."  My dad recently had two knee replacements done and I asked him why he had those done.  He did reply that it was to feel better and be out of pain.  I looked at him and told him that's exactly why I'm having this done.  I have diabetes, sleep apnea, high cholesterol, bad knees, back pain and the list goes on and on.  This procedure will help, if not reverse, most of these conditions.

As my dad thought about all of these points, he brought up the past and told me he wasn't a very good example of what healthy eating should look like.  I reminded him that my mom had those issues as well.  Besides, we all make our own decisions.  I stressed to him that I'm not placing blame, that I just want to live without pain.  It's clear to my dad that I've done a lot of research and have answers for every counter-point of his.  I even looked up current stats to see what the success rate is.  For those that are curious, the current numbers show that eighty percent of those who have the surgery are successful.  That's a pretty good outcome, especially for a guy who is math-oriented.

Now we're at the point where my dad has done a complete 180 turnaround about this.  He told me that he is proud of me for making this decision for my health and he's hopeful it will work.  He even told me he will be here to take care of me afterwards if I need it.  It was more than I could have imagined.  The stress that I had been feeling has now left me.  In fact, I was able to get an amazing four hours of sleep on my CPAP machine last night.  That doesn't sound like a lot, but I find it no coincidence that this happened right after I told my dad about the surgery.  Releasing stress is such an important thing to do.

Now both my parents know and they are supportive.  That's what I have wanted - their support.  This is a scary decision for me and I just need my family at my side.  I'm so glad I'm free of that worry and can keep moving forward.

Water Challenge Day 33:  Drank 150 of 185 ounces

Solutions

I had my appointment with the doctor at the sleep clinic.  He was a very nice man who really listened to me.  I don't know about you, but I have had times when I have gone to the doctor's office and he or she just seemed to not be hearing me.  Not every time, but enough to drive me feeling like something was wrong with me.  When he asked me how my sleep was going using the machine, I looked at him and simply said, "Horrible.  I have slept twice on the machine ... two hours last night and a half hour the night before."  I was grateful for the two hours, trust me on that one, because up to the night before that, I had not been able to string together enough will in me to even fall asleep.  Actually, it isn't my will, but just a pure inability to fall asleep on the machine.  Getting the half an hour and then the two hours felt like a freaking miracle to be honest.  After much discussion with him regarding exactly what was going on and doing a physical examination, we developed an action plan together.  I could tell he wasn't going to just let this go and check with me in six months.  He understands that I'm not sleeping now and need help now.  To be honest, I practically cried while talking to him.  I have spent so many nights in tears from the sheer frustration of not being able to fall asleep yet being so tired.  This has been going on for a solid month.  That might not seem like a long time but I can assure you that not being able to get a somewhat restful night of sleep night after night is a horrible feeling.

To begin, the doctor is changing the two sleeping pills I had to a more intense one that is solely to help with sleep (I guess the other two pills were anti-anxiety meds with a side effect of being drowsy).  My new pill is called Ambien.  You may have seen commercials for it on TV.  It's the one where the person is sleeping and a butterfly flies all around them while they're sleeping.  When I would see that commercial, it would make me jealous that that person could sleep and I couldn't.  Then I remembered that I heard something about people sleep-walking using that med.  The doctor did say that has occurred with a small number of patients.  So he told me to watch out for signs that I had done things in the middle of the night that I hadn't done before bedtime, like making a full meal and then leaving it out on the stove.  The thought of that just cracked me up.  He told me that if I do have those episodes, I am to stop immediately and then we'd go to a different med.  I was looking at the medication guide they gave with it and I had to do a double-take.  In the section where they talk about sleep-walking, it says:

"Reported activities include:

• Driving a car ("sleep-driving")
• Making and eating food
• Talking on the phone
• Having sex
• Sleep-walking"

That made me laugh even more.  I just had this image in my mind of me going to bed.  After a while, I got up to use the phone to call someone.  I then got in the car and ended up eating food at a fast-food restaurant instead of having sex with the person I called, which apparently was my original reason for using the phone in the first place. Ha ha!!  It just struck me as hilarious.   Getting that sort of image in my head is what made me laugh at that.  I'm sure it happens to people, but to think any of those things can happen while I'm dead asleep is pretty laughable.  Apparently people do have functional episodes while sleep-walking to the extent that others around them feel like they are their normal selves.  It's such an interesting phenomena to me.  Of course this is nothing to take lightly and I think you guys know me well enough by now to know I don't take things like this lightly.  On the flip side, I do have funny images that pop into my head at the most inopportune time.  I'm happy to report that none of the above happened when I took the pill last night.

I need to check in with the doctor in a week or two.  If the med doesn't work, the second thing the doctor wants to look at is having me studied more in the overnight sleep clinic so they can monitor everything going on.  He said that, according to the data from the CPAP machine, when I'm wearing the nasal pillow, I am not experiencing apnea.  In fact, I should be able to sleep in any position with that machine on.  He is thinking there is something going on in my brain that is psyching myself out in not being able to sleep on the machine.  He says I may be thinking about it too much and preventing myself from falling asleep.  He didn't say it in a dismissive way, but just that it doesn't make sense based on his experience with other patients.  He does feel that a recliner could help on a short-term basis now and when I have the surgery due to the different body positioning.

We did talk about the possibility of a device that goes in my mouth that will force my tongue forward, thereby opening up the passageway.  Unfortunately, I can't qualify for that device until at least six months after my gastric bypass surgery.  They want to see that I have lost weight first before going in that direction.  Speaking of the surgery, he did say that many patients end up no longer having sleep apnea or a very mild form of it afterwards.  I was reminded that even thin people have sleep apnea, which I know to be the case because I've had class members when I learned how to use the machine that were thin.

I'm beyond thrilled that I slept last night!  Not all night long, but a couple more hours on the machine.  I was so tired that I decided I needed to take off the nasal pillow and just sleep on my own so that I could be as functional as possible today.  The lack of sleep I have been experiencing really has taken a toll not only on my body but on my mind.  I've been slurring my words a little bit and even having to try a couple of times to say one word.  That has all been from being extremely tired.  

Speaking of which, my med is starting to kick in now.  My dad is coming for a visit tomorrow.  I am going to move forward with telling him that I'm pursuing the gastric bypass surgery.  I'm nervous and feeling a bit anxious about having this conversation with him.  I just worry that he won't approve and that he won't be supportive.  It's important for me to have his support.  In the end, I know he does back me in whatever I do, even if he doesn't agree with my choices.  Ultimately, it is my choice and I have to remember that I'm a grown-up and not that 13-year-old that's trying to get the courage to tell her daddy something important.  I'll let you all know how it goes!

Day 31:  Drank 186 of 185 ounces (I rock!)

Saying no to ten more years

I'm not even going to talk about the non-sleeping CPAP situation.  No news means no sleep.  Ho hum.  Someday soon I'll sleep again through the night, at least I hope so.

I was going through my mail earlier today, just trying to catch up on not having checked the mailbox for a few days.  One of the catalogs that came screamed this headline:

Kathy B.

Exclusive offer for being a customer
for over 10 years

This particular catalog was from Roaman's, with the other two coming from Woman Within and Jessica London.  I just have to say that I really want to end my shopping relationship with these companies.  They sell only larger sizes and, except for Jessica London, the clothes are just awful.  No offense to those of you out there that love their clothes, but everything has huge flowers, horrible 60's patterns and polyester everything.  I have always viewed them as catalogs I had to order some clothes out of because I had outgrown the sizes in the stores or were at the tail end of what was available.  I have found some things that were palatable, but really they have always made me feel much older than I really am.  Oh how I wish my relationship with them had only been 10 years.  My need to go to the big clothes store or order from catalogs specializing in plus sizes has been for something like 35 years.  I'm 42 by the way.

That's the thing with being overweight ... it just makes me feel old.  I look like a completely different person when I'm thinner.  I must also admit that I smile more.  Maybe it's because I feel happier, who knows.  I know I definitely feel healthier and can wear cuter clothes.  That's not the reason I'm planning on doing the gastric bypass surgery, not at all.  It's all about feeling and being healthier.  Of course, if I can be cuter along the way, I won't fight that.  I think feeling more attractive, though, is really about how we feel about ourselves on the inside.  Some of the those most beautiful people in the world aren't necessarily beautiful in the conventional sense, but ooze it because of their inner beauty.  Being thin isn't the answer in all times, but there is a boost in self-confidence I feel when I am in a healthier place.

For this coming week, I really want to focus on getting exercise in at least three days a week.  During this last week, I only exercise one day this week and that was today.  That wasn't enough for me.  In fact, it actually made my body hurt more.  So I'm committing to doing that here and now.

Day 26:  Drank 145 of 185 ounces

Experience of others

I'm posting late tonight because I wanted to make sure I got in all of my water beforehand.  Ugh, it's definitely filling!  I don't know how anyone gets all their water in and overeats without feeling like they're going to burst.

On the sleep front, I still haven't been able to sleep with the machine.  However, I did call the surgeon's office and they told me I would have to meet with him in order to get questions answered about my specific situation.  The person who spoke with me did share that they have had patients who are tummy sleepers.  Okay, that was encouraging.  Wanting a little bit more information, I went onto my Facebook group that deals with gastric bypass with members who have either had the surgery or thinking about having it.  I was seeking responses from people who might have had the same experiences after their surgery.  Below is my original posting with their responses.

My post:

I have a CPAP-related question. I've got severe sleep apnea. My problem is that I can't sleep on my back or side. When I start to fall asleep in those positions, my breathing stops and I wake up. I have a CPAP now and my sleeping is worse than ever. I can't sleep with it on, no matter what I try and how long I try. The few times I have started to fall asleep, I not only wake up but it feels like a shock with the machine trying to do it's thing. When I take it off, I'm asleep in 5 minutes when I sleep on my tummy. I know it's important to use the machine and I do have a consult with a sleep doc next week. But has anyone who has already had the surgery that is a tummy sleeper have problems? The doc who approved me for surgery said my sleep position should not affect the surgery, but I'm curious how that would work. Did you sleep on your tummy after the surgery? I'm starting to worry that my inability to sleep on my back/side will prevent me from getting the gastric bypass done.

Responses:

• Try a different mask for your cpap. They have some less invasive masks that tend to freak people out less. You really will feel better if you use your cpap just got to find a mask that is comfortable for you.   And I have no idea about the belly sleep to answer your question. Sorry !
• [This message is from me ... I was annoyed by the message from the person from above - I didn't ask for advise about how to use the machine,  Yeah, okay, I was irritable but lack of sleep with do that to you.]   I should have put in my post that I have tried every type of mask. This has been an ongoing problem for years. Tried the machine a couple of years ago but decided to try again. This is why I'm asking the specific question about other people who are tummy sleepers.
• Your sleep apnea will go away pretty quickly as you lose weight. You won't be able to sleep on your tummy for a few weeks at least after surgery while your incisions heal. After that you'll be good. It's worth getting over the few weeks with not great sleep though because you won't need that machine anymore.
•  I couldn't wear my cpap either.. it gave me migraines.. on a good note, I am two months out, and my bf has told me I o not snore anymore.. I breathe heavy off and on, but nothing like I used too. After surgery u cant sleep on tummy for a bit, it hurts.. even after I was fully healed I tried it, and felt a pulling pressure.. I can now. but def not for first month.
• My sleep apnea and snoring went away within a month after surgery..you can sleep however you want after surgery but tummy might be uncomfortable for a few weeks...good luck.
• Love my CPAP and as the weight falls off they keep reducing the pressure and now I fear I don't need it anymore. It's like having the breeze brush up against my face. Different mask might help, also loosen the mask, and I have no trouble sleeping in any position. For the first month adjusting to it seemed difficult, but then was much better. Also, I got the humidify inc attachment.
• I loved my bi-pap. Please go back to the place that sold you your cpap and tell them what is going on. People die in their sleep, and your body will never renew itself for the next day.
• Bipap is way to go pressure lessons when exhaling much easier to breathe.
• I. Am the same way with my machine. I never used it. And I can only sleep on my tummy. Day I came home from hospital. I was. Sleeping on my tummy. You'll figure it out if ya wanna get to sleep. Lol
• [Me again.]  Thanks for all the great feedback. I'm definitely not giving up on the CPAP or whatever treatment is going to work for me. I have an appointment with a pulmonologist from the sleep clinic next Thursday. He will be looking at the data from my machine as well as have me bring the entire machine in (I'm guessing to make sure I'm wearing it correctly). I have tried loosening it, tightening it, sleeping on my back, on my side, different masks. I've pretty much tried it all and I'm completely at my wit's end. I pray something works soon otherwise I think people will find me in a corner crying from the pure exhaustion and frustration.
•  I felt like that until I joined a internet group, and I asked one questions detailing the masks I had tried, the levitating nasal pillows lol, and someone said "try this one". And I did, and it worked. Used it for about 6 years.
• I have a machine and I sleep in all positions except for the first month after surgery- I couldn't sleep on my stomach. I usually place my hose above my head when I lay down as it allows the air to flow freely. If the tubing is twisted I find I don't sleep well. I also have the full mask and the CPAP pillow which have cut outs for the mask and neck support.  Some times I do wake up with a headache but I believe the temperature need the be adjusted that night which sometimes affect my sinus.   Sometimes the temp that you have it set can make your sleeping uncomfortable. Mine is set at 70 degrees at the moment.
• Kathy, another thought I had is you might want to start and use the CPAP for one hour and gradually work the way up. You are ramping right?

It's clear from the messages that I'm not alone in the inability to sleep with the CPAP.  That made me feel better, as well as knowing that some were even able to sleep on their tummies.  It's so hard feeling like no one understands the things we go through, only to then realize there really are others that understand from personal experience.  It's really hard to describe the frustration I have gone through with this.  The inability to sleep is just awful, especially when you need to be somewhat functional throughout the day and particularly when driving behind the wheel of a car.

What I have decided is to try to let it go as much as I can.  Otherwise I'll cause myself (more) unending stress and anxiety.  That's the last thing I need to bring on for myself.  I have an appointment with a doctor from the sleep clinic on Thursday, so I'll see what he has to stay.  In the meantime, I'll do the best I can to get some sleep.

Speaking of which, I have an early morning walk with Sara and her two doggies.  I'm not going to use the machine tonight so I can ensure I will have enough energy to walk tomorrow.  Looking forward to that!

Water Challenge Day 25:  Drank 186 of 185 ounces 

Trying not to stress about it

It seems like this issue with my inability to sleep with the CPAP machine has been overtaking most of the space in my head.  Last night I decided to sleep sans the machine and I fell asleep in about five minutes.  I remember my head hitting the pillow and then I was out like a light.  The truth is that I sleep so much better without the machine that is supposed to help me sleep better.  Ironic ain't it?  Two reasons keep me trying the machine.  First, it is incredibly dangerous for my heart and overall health to live with unregulated sleep apnea.  The research I have done has more than convinced me that I have to keep trying.  Second, I am going to have the gastric bypass surgery later in the year and if I can't sleep on my back, how am I ever going to recover after surgery?

This issue with surgery recovery has been really weighing on my mind a lot.  I know that, for many people, they no longer have sleep apnea sometime after the surgery.  Imagine, having this incredible surgery to have a healthier and longer life.  You're in the recovery room and all of a sudden you can't breathe because you wake up every time you fall asleep.  And the doctor tells you not to lay on your stomach because your incisions need to heal.  So you're lying there in a dark room, struggling with a CPAP machine that only keeps you up and prevents you from sleeping.  Your eyes hurt from being so tired but you Just.Can't.Sleep.  No matter what you do, you Just.Can't.Sleep.  Tears are falling from your eyes out of frustration in not being able to fall asleep without losing your breath.  This is what I'm going through right now.  I lay there with every good intention that this will be the night that I will fall asleep with the machine, even if it's just 15 minutes.  It never happens.  I'm talking never, ever.  

I decided to be proactive today.  Instead of sitting here in wonder, I decided to send a message to the doctor who approved me for the surgery.  I am seeing a pulmonologist next week, but I don't know if he can answer questions about the specifics on the surgery.  I know I'm being impatient, I completely own that.  Yet, the worry about what will happen after surgery is messing with my head so much that I just had to ask some questions to find out if I should worry or if I can relax a bit.  So here's what I asked the doctor in my message:

"Hi Dr. R,

I am currently participating in the Options program leading to a gastric bypass surgery.  I have a question I'm hoping you can help me with since I don't have a surgeon yet with it being too early in the process.  I was diagnosed with sleep apnea a couple of years ago, tried the CPAP machine but gave up because I just couldn't fall asleep.  However, I have decided to try again because I know how important it is to be on the machine.  I am still having extreme difficulty and cannot sleep on my back or side.  I lose my breath and wake up.  I have an appointment with the sleep clinic to see how I'm doing.  However, in regards to the surgery, is it possible to still have the surgery if I'm a tummy sleeper?  I'm just worried I won't be able to have it if I can't sleep on my back/side.  If you could provide me with some insight, I'd appreciate it.  Thank you."

So I sent it off with bated breath, hoping the doctor would help me feel better or at least alleviate the worry I have going on inside.  Here is his very detailed response:

"The condition or way you sleep should not interfere with surgery.  Thanks."

Okay.  Mr. Personality he is not.  I might look into whether or not I can contact one of the surgeons that actually perform the surgery just to be certain because his response left a lot to be desired.  He does not perform the actual surgery, but does the final approval for Kaiser members in the San Diego area that want to move forward with the surgery.  

These are the things that take up space in my head and make me want to eat when I'm left with more questions than answers.  And I have to admit that I really wanted to eat today.  Instead, I drank water.  Ho hum ... water.  It didn't give me quite the thrill that a scoop of ice cream does, but it shouldn't be doing that anyway.  Sorry I seem to be talking about all the CPAP trials and tribs lately.  It's just all-consuming for me because I'm very tired, physically and emotionally.  It has wiped me out and I feel non-functional lately.  I'm sure I'm handling things better than I think in my head but I'm just exhausted.

Water Challenge Day 23:  Drank 185 of 185 ounces

Seriously not trying to complain but ...

So my saga with that freakin' CPAP machine continues.  Have you ever been so frustrated with something that you just wanted to cry because you just honestly don't know what to do with yourself?  I passed that place last night.  My doc prescribed some deliciously yummy sleeping pills that, under normal circumstances, would be a special treat for any problem sleeper.  Imagine floating on a cloud the moment your head hits the pillow and then waking up like Sleeping Beauty in the morning.  Doesn't that sound heavenly?  How about the sleeper that is very tired but is fighting a machine to see who's gonna win?  Side note:  the machine won.  Grrrrrr.

I honestly feel like I'm at the end of my rope.  I'm still trying, I promise.  I am going to bed each night with renewed spirit and a hope that this will be the night that I fall asleep on the machine.  I try to block it out of my mind and not think too much about it.  Yet, when you're trying to fall asleep after 3, 4, 5 hours and just can't get there, what else can you do but practically weep in your pillow?  There is a point that I just have to take the straps off so that I can get at least some sleep.  I do need to be functional in my job somehow.  If you're a praying person, please throw out a prayer or two on my behalf.  I would appreciate that so much.  I know how dangerous sleep apnea is left untreated, so I will continue trying until I see the pulmonologist.  Hopefully he'll wave a magic wand at me and I'll become Sleeping Beauty.  Dare to dream, right?

Totally changing topics, I shared a few days ago that I got into grad school to pursue my master's degree.  After spending the weekend thinking about what is the best course of action for me, I've decided that I'm going to wait until the Fall term to start my classes.  If I start now, I would have to start in second year classes and that feels a bit backwards to me since I'll then need to take first year classes afterwards.  So now that I have more months without school, I'll need to work on scholarships and different ways to pay so that I can avoid taking out more student loans if at all possible.  I hate borrowing more money, although I will if I have to do that.  It's important for me to get the master's degree so that I can move on to the next level in my profession.  One of the things I do in my job is help students with obtaining scholarships.  I guess now I'll have to use some of those skills for myself!  Alright, time for me to take that sleeping pill and then have a great night of sleep (positive thinking all the way man!!).

Water Challenge Day 21:  Drank 52 of 186 ounces (yeah, okay, I did bad today)

Pre-op class #3 and weekly weigh-in

This week's Options class was about embracing change.  Ah, change ... one of the most difficult things for most people to deal with.  I don't know many people that really love change.  If anything, most of us just deal with it.  Of course, it can be very positive as well.  I recognize that my process leading up to the gastric bypass is a series of many different changes.  My challenge will be how willing I am to handle them head-on or if I will try to bury my head in the sand.  With change comes choice.  The fact is that I can choose to change or I can choose to stay stagnant.  That's the beauty of this entire process - all these things are up to me.  I am challenged to look within and see if I am really willing to do the work or if I just want to get away with the base minimum.  It's an interesting thing to think about.  Obviously I want things to be better and to feel healthier.  But the question is if I really do want it.  Do I want to be able to eat whatever I want, whenever I want or do I sincerely want to live a healthier life with healthier choices?  There's this pouty little girl inside of me that says, "Ick, how boring!  Enjoy that life eating rabbit food."  Yet, there's that other part of me that is tired of feeling aches and pains all the time.  She wants to breathe better, no longer have diabetes and just live a longer, more vibrant life.

There were some practical things I can do to continue countering negative beliefs and feelings into positive ones.  One of the challenges for me this coming week will be to immediately counter any negative thoughts I may have about myself with something positive.  Many people who have weight problems say a lot of negative things about themselves, myself included.  I can't even express how many times I'll pass a mirror and say something negative as I look at my reflection.  It's horrible that I do that because no one deserves it and, really, that's the whole point of the exercise.  Speaking of making change, one of the charges we have throughout the classes is to start incorporating practices now that will help us transitioning after the surgery.  One of the great tips was to try to eat slower by using baby utensils or, even better, use chopsticks.  Sounds like a great idea but I can't use chopsticks!  I never mastered that skill. I'd be sitting at the dining room table 2 hours after everyone else has left if I ate with them. The more I thought about it, though, the more I thought it was a great idea.  This will definitely slow me down if I'm hurrying and I'll learn something new.  See, I'm picking up all kinds of talents and skills along the way in this journey.

My weigh-in this week was pretty nice - I lost a couple of pounds.  I'll gladly take it!  My water intake has been pretty good overall.  I just need to figure out what's going on with using the CPAP machine and I think I'd be feeling fantastic.  Lack of sleep is extremely frustrating.  I saw one of my doctors today and she prescribed some sleep meds to use in conjunction with the machine, so hopefully that'll just knock me right out.  I pray I will fall right into bed and sleep the whole night through.  Mmm, that sounds devine!

Water Challenge Day 20:  Drank 168 or 186 ounces

Trying again tonight

I did not walk during lunch today at work because I had some things going on and I have to admit that I missed it.  While I may have been sweaty doing it yesterday, there were great benefits that I felt from doing it.  Tomorrow I'm planning on giving it another go.  It feels so good to take good care of my body, even on days when it hurts.  The same thinking revolves around my 100-day water challenge.  In fact, I posted on my Facebook page tonight and asked if anyone wanted to join.  There's about eight of us doing it at work and I find it so much easier to have the encouragement of co-workers, even if they roll their eyes at me as they walk to the bathroom.  Ha ha, I love it!  A few more people got on board, so we'll all be running to the bathroom together.  I do find it is so much easier to be healthy around other people when they are practicing healthy behaviors, too.  I'm trying to incorporate as many good habits now so that there isn't such a major adjustment when it comes time for the gastric bypass.

I did not use my CPAP machine last night.  I decided to give myself a break from it because I absolutely struggle to sleep with it on my face.  There is something preventing me from sleeping.  So I decided to go online to see if I could find any CPAP sleeping tips.  The common thread I saw was to actually not take a break from it and use it consistently every night, even if I struggle to fall asleep.  My biggest problem is either that I just can't go from being awake to actually falling asleep and then, when I do, the air obstruction wakes me up when I sleep on my back or side.  The advice was to get up and get away from the bed if I've been struggling to fall asleep after 30 minutes, go do something for a bit and then go back to bed when I'm ready to sleep.  But no matter what I do, I should not give up on it because anytime I take the nasal pillow off, the apnea returns.  Man, I don't like this at all!  I'm going to keep trying though and I'm sure it's gotta stick sooner or later.  I just pray it's sooner.

Water Challenge Day 16:  Drank 147 of 186 ounces

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.

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.