I wonder what "full" feels like

I'm ready to escape on out of this hospital!  The staff has been great and they have taken good care of me, but I have cabin fever.

Another surgeon from Pacific Bariatric was doing rounds this morning so I didn't get to see my doctor for a check-up.  However, this surgeon was just as great and pretty funny.  Turns out he is the father of one of the teachers I work with at the high school.  He said I was doing wonderful so I asked him if I could go home today.  He cut me off with a very emphatic "NO!" Well, I did have to try.  He said I should be able to go home tomorrow though.  I was released to take a shower and start having liquids.  I have to say that was one of the best showers I've ever had.  After not showering for two days and having had surgery, I just felt yucky.

My experience with liquids has been interesting. I walked 10 laps around the floor early this morning (34 total for the day) so the head nurse said I could have a Popsicle.  Oh boy, oh boy, oh boy!!!  It was sugar-free, totally allowed and delicious.  

Later on, I was told that I could have up to two one-ounce cups per hour of fluid. I was started off with Crystal Light.  I took tiny baby sips and that seemed to go well.  Later on, I had chicken broth and it was good, too.  I requested more Crystal Light so the nurse brought me some more with ice chips in the cup.  I gently spooned enough to go in the one-ounce cups.  

The first one was great and, though it took me a long time to finish, I did a good job.  When I worked on the second one, I must have put too much liquid in my mouth because I feel sick to my stomach right now.  I don't know if this is the full feeling they said I would experience, but it feels like a tummy ache.  It is going to take time and practice for me to get used to this new pouch.  I can't gulp like I used to or have too much.  When I look down at my tummy and see the five tiny incisions where the surgeon operated, it doesn't feel real somehow.  The uncomfortability does, though.

I also had visits from a physical therapist and dietician today.  The physical therapist talked to me about how to get in and out of bed.  Sounds like an easy thing to do but when you have had major surgery on your stomach, you have to be able to rise out of bed without hurting yourself.  The dietician was a great source of information.  She talked to me about specific questions I had upon returning home from the hospital and which protein shakes might work best for me given my lactose intolerance.

Each day is going to be full of learning for me, but that's okay.  I want to maximize this incredible opportunity before me.  Oh, I almost forgot some really fantastic news ... I think my diabetes is going into remission!  The first few readings were high after surgery because of the dextrose in my IV bags but it is leveling out.  I just had a reading of 102, so I'm hopeful about that. More to come on that front.

Telling other people about my surgery

In the last nine months since I started my journey towards surgery, besides my family, I pretty much only told people in the office at the high school where I work and very close friends.  I wasn't trying to keep it a secret, but I also did not want naysayers to come out of the woodwork.  People have this uncanny ability to tell you their opinions of how wrong you're doing something, unsolicited or not.  Trust me, when it comes to weight loss methods, a lot of people believe you're just not trying hard enough or that you're lazy or some other such thing I have heard a million times before.  They don't think things through very much before it comes out of their mouths.  Clearly weight loss surgery is not the first thing a person does to try to get healthier.  For me, it has been a million diets and desperate attempts to drop the weight.  Most people are well-meaning, but I wanted to focus on my process and not worry about possible negativity coming my way.  Since I'm less than a week away from my surgery date, I decided to share the news on my Facebook page to let everyone know what's going on.  Here's what I wrote:

Friends and family,

I have some important news to share with you so Facebook will help me do it all at once if I haven't had the chance to tell you in person.  If you have known me for a long period of time, you have known that I have struggled with my weight since childhood.  I have tried so many different ways to lose it, some successful for a period of time, but it would inevitably come back on.  Along with it have come diabetes, high blood pressure and other ailments.  My body is constantly in pain, even if you can't tell from the outside.  Finally, with much contemplation over a period of years and prayer, I began the process of pursing weight loss surgery this past November.  After many tests and six months of classes, I'm thrilled to share that I will be having gastric bypass surgery this Friday.  While many in society believe it is the "easy way out", I can assure you all it is not.  It takes a lot of commitment and sacrifice on my part to undergo such an invasive procedure that will affect the rest of my life but one that leads to a great quality of life and wonderful health.  My last day of work will be Wednesday, but I have a great sub coming in to handle things while I'm away.  This is major surgery so I will be out for awhile.  I have pre-op stuff on Thursday and then the surgery at 7:15 a.m. Friday morning.  The procedure is being performed by an excellent surgeon who is part of a center of excellence, Pacific Bariatric.  I will be at Scripps Mercy for three nights, so visitors are welcome!  Thanks for your love, support and prayer.

What happened after that was something beautiful.  I received so many lovely comments and personal messages.  As I read each one, my eyes filled with tears and I felt pure joy inside.  I received message after message of support, love and encouragement.  I even had three people tell me privately that they also have had bariatric surgery recently.  I didn't know they had done that.  I am so blessed to have such wonderful people in my life who clearly love me more than I knew.  I mean I knew, but I didn't really know.  I sit here feeling such peace around all of this, which is sooo unlike me.  Not too long ago, I was feeling very anxious and nervous.  Now I'm the polar opposite.  People have told me that is because I'm ready.  Who knows, maybe I am.  Right this minute, I feel truly touched by God for placing such amazing people in my life.  He is so good!

One week to go, information overload

In a week from today, I will be in recovery from having gastric bypass surgery.  That fact really hasn't hit me yet.  I have really been taking things day to day, which is the healthiest thing I can do for myself, but also because it feels like that's the most I can manage right now.  When I received the news about my surgery date, of course I was elated and shared it with others.  Then I had to get down to the business of preparing myself for being out of work for up to six weeks.  That's the amount of time the surgeons release us, although we can go back to work if they deem we are ready sooner.  For me personally, if I need the six weeks, then by God I am taking that time.  I am not going to rush my body before it is ready to go back to normal activities just because I can.  This is major surgery and I'm certainly not going to minimize that nor have shame in taking the time I need.  

In the midst of preparing things at work for a substitute to come in, I have also been trying to read up on the things I will need to do leading up to the surgery and afterwards.  During the six months of pre-op classes, Kaiser prepared us very well.  I must say, being on the other side of the experience, I am grateful they were so thorough.  Before starting the classes, I really had a hard time with the fact that I would be required to attend six months of classes.  I felt like I had made the decision so let's get on with surgery already.  Yet, they touched on so many issues to help prepare patients like me for a different lifestyle.  This is, by far, not an "easy way out", as some believe it is who judge from the outside looking in.  In fact, our facilitator of the group told us several times this is a more difficult journey, yet one that will give us a better quality of life.  I am also taking in the information the surgeon's office has given me.  At the consultation, I was handed a CD with a file on guidelines leading up to the surgery and afterwards.  This document has a lot of very good information, but it is a lot to take in when I couple it with the information given to me from Kaiser.

Not all of the advice from Kaiser coincides with that from Pacific Bariatric, my surgeon's office, and vice versa.  For example, Kaiser advises us to choose clear liquid protein supplements the first three days after returning home from surgery, such as Isopure Perfect Zero Carb or Syntrax Nectar Whey.  However, the surgeon's office states we should have clear liquids and a liquid protein supplement, but a clear liquid protein supplement is not necessarily stated outright.  So, do I stick with a clear liquid protein supplement or just a regular one?  I have decided that for those first three days, I will go ahead and get some ready-made clear Isopure so that I'm satisfying both recommendations.  When I was going through the classes at Kaiser, I remember being told that the surgeon's office wasn't going to give us much information, but I wonder now if they just didn't know what we were going to be given. Kaiser is heavily involved up to the point where we meet with the surgeon and then they step back, working in conjunction with Pacific Bariatric but allowing those doctors to take primary lead.

Regardless, it is a huge amount of information from both sides.  Being the detail-oriented person I am (yeah, alright, anal retentive to some degree), I'm doing the best I can at studying everything.  I feel like I'm back in school and I'll be tested before I can be released from the hospital.  

How long do you have to be on clear liquids?  

When can you eat chicken again ?

Are you allowed to drink caffeine?

How often do you have to take your vitamins and calcium?

Why can't you chew gum?

How long is it before you can start eating fruit?

Oh my gosh, there are so many rules!  Obviously I don't want to make mistakes when it comes to things I need to be doing to take care of my body after surgery, so I need to know this well.  Thankfully I am not traveling this road alone.  My classmates and I have been very good friends and we're all supporting each other routinely.  I lean on them so much to keep me grounded.  I also have an incredible support system among my family, friends, co-workers, therapist and, of course, all of you.  Between this blog, Twitter, Facebook gastric bypass groups and Instagram, I have a huge community of support.  I am incredibly blessed to know God is taking such good care of me and arming me with all the tools and resources I need on this journey.  Even with the information overload, I'm still doing well.  I'm looking forward to the surgery and the much improved health afterwards.  As I sit here and write this, my back and leg are in pain, yet it calms me to know that perhaps very soon into the future, I will start feeling less pain as the weight (I pray) continues to come off.  I'm really looking forward to that.

I have a surgery date!!

As I posted in my last update, I have been impatiently waiting for that phone to ring to schedule my gastric bypass surgery.  I went back to work today after a two month summer break.  It was nice to get away from my head and focus on other things.  The only problem is that I seemed to think about it more!  I had my cell phone in my pocket everywhere I walked today when I was in the office ... to the copy machine, bathroom, health office.  I admit it - I was obsessed.  Finally, at about 1:30 p.m., after I knew Pacific Bariatric staff were back from lunch, I just couldn't stand it another minute and decided to call.  What, you're surprised?  LOL

When I got on the phone, I was very casual with them, "Hi, I'm just calling to see if we were ready to schedule my surgery!"  Be light and breezy, Kathy.  The surgeon had given them the slip that morning to schedule me.  When the person helping me asked me if I wanted a specific date or just the next available surgery date, I figured it would be weeks so I asked for the next available.  She told me that she would call over to the hospital to check on availability, but that it looked like they had next Friday open.  WTF, next Friday??  Wow.  So, long story short, here I am, booked to have my surgery on Friday, August 22nd at 7:30 a.m. I have to check in at 5:30 a.m. which means I will be getting up that morning at about 4:15.  As if I'm actually going to sleep!

When I got off the phone, I was in a state of shock I think.  It registered with me, but it wasn't really registering with me.  That's less than two weeks away.  I got up from my desk and proceeded to tell my bosses and co-workers in the office.  Amazingly, I wasn't anywhere as anxious as I imagined I would be at that moment. I was feeling nervous, sure, just like anyone else would be in my position.  I believe strongly that my faith, strong support system, this blog and mindfulness classes have really help me stay in the moment as much as possible.  I need to remember to breathe and put one foot in front of the other.  Of course I will be continuing to write about it all here.  If you are a praying person, I ask that you send whatever prayers you can for me to give me strength as I walk through something I thought I would never be brave enough to walk towards.  Stay tuned for more.

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 ;-)

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.

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 #16, weekly weigh-in and thrown for a loop

I have a deep suspicion this post is gonna be a long one - a lot has happened since my last post.

First off, thanks so much for your sweet messages from my last post.  Reflecting on my experience with cancer has really helped me actually be very centered for things that happened Monday and Tuesday.  Looking at my own scar from my back seems pretty surreal.  Most of the time, I forget the scar is there unless I'm having pain from the scar tissue, which tends to be on a regular basis, or I catch a glimpse of it.  Regardless, I'd rather have the scars than cancer.

On Monday was my regular pre-op bariatric class.  I was a tinge disappointed with my weigh-in results this week, having lost two pounds.  I have to keep reminding myself that all of the losses are adding up, so it does not have to be a gargantuan number.  In fact, even though our goal is to lose ten percent of our body weight before going in for the surgery, the doctor who approved me said I'm okay if I don't lose weight but I just shouldn't gain any.  Besides, these additional two pounds brings me down to 77 pounds from my heighest weight.  So, I'm reminded that the bigger picture is the most important piece of this.

We're done with week 16 now, which was about post-surgery exercise.  We have just eight weeks left.  Wow!  We discussed the things that we can start doing now to ensure as much success as possible after the surgery.  For this week's class, our regular facilitator wasn't there so our structure was a little different with a sub.  This class was particularly odd because a stranger just happened to walk into our room by accident.  The place where our class is situated is in a corner room, so most people don't come there unless they are specifically looking for it.  It turns out that she was looking for a person in one of the classes, but it was the wrong time.  This person, though, had bariatric surgery six months ago.  We took the opportunity to ask her questions while she was there.  It was pretty funny because she stood in front of our class for about 45 minutes and gave us an impromptu talk on her story.  She had gastric bypass surgery and we haven't had one of those speakers yet, so we threw a million questions at her.  She was a great sport, though, because she answered every single one and even ended up showing us her tummy to let us know what the incisions looked like.  Imagine that ... a complete stranger lifting her shirt and showing us her tummy.  I loved that!

Prior to her walking in the room, I was one hundred percent all about the sleeve.  I had my mind made up that it was going to be the surgery I would select when it was time to let the surgeon know my decision.  There was absolutely no question in my mind. Then she shared her experience and I sat there almost in stunned silence because I was seriously starting to question my decision.  I know that everybody has a different story.  Some people have a great surgical experience and some are not so great.  I know that deep down inside, especially with all the research I've done and talking to various people online.  I have a good friend that had the bypass as well and I will often throw random questions her way.  She very sweetly answers them every single time [thank you for that my love!].  With the telling of her story, the person who happened to walk into our class told us about the fact that she had no pain from the surgery, no side effects, being able to be more active with her kids and so much more.  She also talked about the difficult parts, like mourning over not being able to eat certain foods and having an episode of dumping.  Yet, she kept saying, "You guys will be fine, you'll be just fine."  No matter what difficulties came up, she reiterated that she had absolutely no doubts about her decision and wished she had done it sooner.  I listened to her story and I thought to myself, "Gosh, that doesn't sound bad at all."  I keep wondering what I was so afraid of with the bypass.  I listed to her, asked questions along with other people and left there feeling struck with a million more questions inside.

What have been my issues with the bypass?  Well, for one, the malabsorption that occurs is a concern.  I thought about the fact that I would have to take supplements for the rest of my life.  I never went to the place of consideration that I'm already taking medication, so what's the big leap?  If I don't take my insulin, for example, I'm pretty screwed.  Then the idea of having my intestines moved around scared me.  What if they surgeon makes a mistake?  What is my course of action at that point?  It's a permanent surgery and my system will be forever changed.  Okay, that's a valid concern.  I also had thought a lot about stories I have heard of people gaining the weight back and other possible complications.  I was forgetting that the sleeve comes with its own potential issues.  Yet, that stranger's talk was replaying in my head and I wondered if perhaps I was closing my mind to at least being open to looking at the other side more.

The next night, which was last night, I had the infomation session with a surgeon at Pacific Bariatric.  It is a requirement for us to go to at least one information session prior to being referred for surgery.  With the discussion from the previous night replaying in my head, I reminded myself that I needed to have an open mind and be as honest with myself as possible.  As I drove up to the hospital, was incredibly nervous.  As I looked at the buildings, I was hit with the realization that my life would be changing forever in one of those rooms in just a few months.  Holy crap!

Our session was in the auditorium of the hospital.  I chose a seat right in the front.  I work in education, so I always rationalize to myself that I'll learn better if I'm sitting in the front.  I sat literally in front of the doctor - no better seat than that as far as I'm concerned.  I must say that he was absolutely amazing and I hope I can choose him as my surgeon.  He had an incredible bedside manner.  He was personable, spoke concisely, educated us and made himself available for absolutely every question the audience threw at him.  His approach to the issue of surgery was to first help us understand about the nature of obesity.  He didn't just stand in front of us and tell us we were overweight because we ate too much.  He came right out and described how obesity is a disease.  He talked about the factors that go into it, such as genetic, environmental, psycho-social and more.  I wanted to get up and give him a big hug because I felt like he "got" it.  This isn't just about this particular surgeon, but the entire Pacific Bariatric practice.  The approach was much more than just about the surgery itself, reminding us that this is not a diet but a new lifestyle.  Many doctors do judge patients who are overweight.  Yes, they are quite caring, but I can't tell you how many times I have been looked over and judged by the medical community for my weight.  I didn't feel that at all last night.  I just can't express enough how absolutely impressed I was with the talk.

Because I had such a primo seat, I was able to really pay attention when he demonstrated how each of the surgeries work and what our bodies look like internally before and after.  I wanted to focus, so I didn't take any notes until I got home.  This is such an important decision in my life with such a major surgery.  It is going to affect the rest of my life, so I wanted to be present enough and open enough to hear everything.  In my mind, I was really starting to focus more on the bypass and less on the sleeve, just like I had in the impromptu talk the night before.  As a diabetic patient who has sleep apnea and other issues, I needed to know what was the right choice for me.  As if reading my mind, the discussion started going in that direction.  The doctor told us that, when we meet with a surgeon, we will talk about all the options and select the one that is going to serve us the best in terms of long-term success for our specific needs.  My surgeon will not be telling me which surgery to have, but he will be giving me his recommendation as we discuss my options together.  There were a couple of things that really stuck out for me:

• If a person has a severe case of diabetes and is taking insulin, they recommend the bypass.  While it is possible to go into remission with the sleeve, the chances are much better with the bypass.  I knew this, but the doctor was pretty clear to say that those on insulin benefit much more with the bypass than those just taking oral medications.
• If a person has more than 150 pounds to lose, they recommend the bypass.  While people can lose a lot on the sleeve, and many have, the chances for losing all my excess weight and getting into a healthy BMI range is great with the bypass.  The very idea of being in a healthy weight range brings tears to my eyes. 
• The rate of complications is very low with the bypass.  Their statistic is that one patient in every two thousand, or .28 percent, may have a complication.  In the over 16,000 bariatric surgeries they have performed, only four had to go in for revision surgery because of a complication.  They have only had one death and that was not related to the surgery, but it did happen a month after it was performed.  In fact, they are a center of excellence and have the best morbidity rate in the nation.  In the nation.  
• There is thirty years of data that backs up the success of the bypass versus no long-term data for the sleeve since it has only been around for nine years.  This does not mean the sleeve is not a great surgery, but there just simply is a lot of history with the bypass.

If you haven't figured it out already, I am seriously considering the bypass again after the talks on both Monday and last night.  I believe in my heart, stronger than I can ever express in words, that it was God's hand at work that our visitor appeared in class on Monday.  Had she not come in, my heart would not have been as open to the possibility of the bypass in yesterday's information session.  His hand was at work as well last night with such an impressive surgeon.  I am praying that I continue having an open heart and a willingness to search my soul for the truth of what is going to be the right decision for me.  At the end of the day, the decision is going to be mine and mine alone.  Clearly I am going to take everything into consideration, but I also know that I have to be honest with myself.  Don't I want to give myself the best opportunity for long-term success and  the possibility of a healthy, long life?  Of course.  

Been loving my vacay

Hi gang ;-)

I've been on Spring Break this week.  It's one of the absolutely lovely parts of working in education ... when the kids are off of school, I'm off of work.  I apologize for my absence the last couple of days.  I have been trying to stay active this week.  I've had the great opportunity to see some friends that I don't always get to see.  I went walking with them since we've been having such gorgeous weather, having lunch or dinner get-togethers and just enjoying our girl talk time.  I even allowed myself some alcoholic yumminess yesterday.

I don't drink that often, but like to have something once in a while.  A friend and I went to The Elephant Bar for dinner, both choosing to have two low-calorie options and splitting them with each other.  That was beyond delicious.  Then we decided to have a cocktail afterwards since they had some drinks that were all under 165 calories.  That was right down my alley.  Hers was a Skinny Snap Dragon Martini on the left and mine was the Skinny Mango Mojito on the right. So delicious!

I started switching up my food a little and been having more protein drinks.  The surgeons from Pacific Bariatric recommend patients start incorporating those into our food plan prior to surgery to aid in weight loss.  I usually drink the Premier Protein drinks from Costco.  If you're looking for a good protein drink, I highly recommend these.  The chocolate ones taste just like pudding.  Just sayin'.  The only problem for me is that they are super thick and really feel like I'm actually drinking pudding.  I love frothy drinks because I put in extra ice in a blender, but there's a difference between that and drinking pudding so I decided throwing it in the blender would be great.  I took one carton of the Premier Protein, with it's 30 grams of protein, put a splash of light vanilla soymilk, a couple of strawberries and blended it all with ice.  Look what came out.

It was amazing.  It reminded me a little bit of when I was doing Optifast and I would mix all my shakes in the blender with ice.  Of course it tastes nothing like those shakes (in a good way).  Those who are on the program or have been on it know exactly what I'm talking about.  For me, it's been a great and easy way to have my breakfast or a snack that is really satisfying.

For the rest of this weekend, I'm planning on continuing to get regular exercise in.  Since I purchased my lovely Fitbit, I have been incredibly active every day.  There was one day were I didn't reach my goal of getting 10,000 steps in but that was because my knee was hurting.  Otherwise, I have been able to meet that goal or even go past it.  Seriously, if you are on the fence about getting one or need some motivation for extra exercise, go get one.  It has been an amazing way for me to increase my exercise every day.  In fact, I find myself parking further away, walking far out of my way or not multi-tasking when it comes to doing everything in one trip (like piling all of my folded laundry in my hands and bringing it into my bedroom all at once).  You find reasons to get more steps in.  I even did 45 minutes of walking/jogging in place again at home this evening.  Sweat was actually dripping down my chest and I loved it.

Water Challenge Day 78:  Drank 120 of 178 ounces 

Pre-op class #11, weekly weigh-in & the dental hygienist from hell

Among the things that I had scheduled today was an appointment at my dentist's office to get a cleaning.  I also somehow have a chipped tooth, so I knew I was going to be there for awhile today.  I'm not one of those people that hates going to the dentist.  I like the feeling of having a really clean mouth and, except for one time, all of my experiences have been good.

Make that two times ...

My dentist has a thriving practice and she is awesome.  The hygienist that was working on me today, however, was new, at least to me.  I was sort of looking forward to my regular person because he's always been very chatty and is gentle on my mouth.  This one was like evil Nurse Ratched.  She had me laying down on the chair and every time she went to grab a dental instrument, she would hold it in the air, inspect it, turning the blade or hook this way and that and then lower it into my unsuspecting mouth.  Mind you, I'm watching all of this from where I'm trapped.  Then she would scrape and scrape and scrape some more.  It was if she was taking a chisel and chipping away at imaginary icicles in my mouth.  Several times I had to raise my hand to ask her to be a bit more gentle.  She sang while she worked, yet I had no idea what it was - something incoherent and evil I think.  Oh, and the absolute worst, she would let too much fluid build up in my mouth before she sucked it out with that straw thingy.  Ewwww!

Bleh.  On to my class and weigh-in.  For this week, I lost a pound.  I was disappointed with it.  Two is a low number to me, so one was almost as if I gained.  I have to keep remembering that this is no race to the finish line and I'm doing everything I am supposed to be doing in terms of what I'm eating.  I do need to kick up my exercise though.  I just don't think I'm getting enough in.  I asked my friend if we could start walking again at lunch starting tomorrow.  We were both excited about that until we found it it's going to rain tomorrow and Wednesday.  Boo.  I do have a gym membership so there's nothing that's preventing me from staying away from a workout indoors.

This week's class was about assessing my new relationship with food since starting the bariatric pre-op classes 11 weeks ago.  Some of the questions I need to ponder this week include:

• What factors in my current lifestyle contribute most to my obesity?
• What do I need to do to commit to lifestyle changes that support my health?
• What weight do I think is my optimal healthy weight?  Have I ever maintained a weight as an adult that was comfortable and felt good to me?  What felt good about that weight and will I be satisfied to be that weight again?
• What style of eating will fit me best?

There were more questions, but those are the ones that jumped out at me the most.  One of the things that amazes me about these classes is that we're not just skimming over surface-level topics.  We are really diving in to the heart of what has brought us to seek bariatric surgery in the first place.  I appreciate that because I want to go deep with all of this, even when it's difficult to face the answers to the questions.

In a discussion with our facilitator, we addressed a concern I had, which was, "What if I don't lose the 10% weight loss that Kaiser wants prior to having the surgery?"  Our facilitator assured me, and my classmates, that people who do not meet the 10% loss will need to see the doctor in charge of the program at Kaiser to review where we're at.  Essentially, all patients move forward to the bariatric center that will be performing the surgery, but the surgeons at that center may request additional weight loss before surgery can occur if they deem it necessary.  The best I can do is try my hardest to reach my goal of losing 37 pounds before finishing this part of the program.  I'm almost halfway there already, so that feels good.  Once we're done with the classes, we will then go for a fitness test and lab work before everything is forwarded to the Pacific Bariatric center.  Then, they will contact us to schedule three appointments on the same day - meeting with a psychologist, internist and then with the surgeon.  During the meeting with the surgeon, we'll then book the surgery date.  The end of the classes is several months away, but we're almost halfway done and I know the time will go even faster as we get closer to summer.

This week I'm going to work on the questions I mentioned above and then I think I'll post them on here.  That keeps me honest.

Water Challenge Day 68:  Drank 179 of 179 ounces

My highly stressful day

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

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

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

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

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

Hoooooray!!!

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

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

Spilling the beans

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

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

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

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

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