Working it

Things have been going well.  Both my father and brother are out of the hospital, thank you, God.  My father now has about two months of recovery at home before they re-do the hip replacement.  He is in very good spirits and has such a positive attitude.  I respect him so much for having the strength to get through everything he has been dealing with without breaking down.  He had a hip replacement that got infected, had the hip replacement removed, a spacer inserted, has been in the hospital six separate times, rehab for the last six weeks or so and then has to have the hip replacement redone.  My brother has been put on new medication and they are hoping this will work instead of having a new heart transplant done.  If not, he will go back on the list in a few months.  I continue to pray daily for my family.

I started working with my personal trainer.  She is just so awesome and it was such a great decision on my part.  I'll be working with her for three months.  We will be checking my weight and measurements every three weeks.  I shared with her my experience of having weight loss surgery and my attempts of weight loss.  She was in awe of me and actually told me that I was an inspiration to her.  Wow, I had to pick my jaw off the floor.  I started a separate page on here for all of my strength training workouts if you'd like to follow along or at least get the benefit of a personal trainer without having to pay for it.  There's a link for it at the top of the page.  I'm doing things with her that has taken every ounce of courage to do in the middle of the gym.  When people work with personal trainers, others in the gym watch.  It's a very big gym so this isn't easy.  One time I was doing cardio while she was training someone else and I swear every pair of eyes was looking in the corner where she was doing the training and watching.  Yet, I don't let that stop me.  I've even done weight lifting in the section where all the men with muscles do the majority of their work.  What's been interesting for me is that they are not looking at me and mocking me for being the fat lady trying to work out (which is what I had envisioned in my mind).  Instead, they are looking at me and smiling, even checking out my legs when I stand in front of the mirror focusing on my form.  It's been so weird!  I almost feel, dare I say, normal.

I also have seen the dietician at Kaiser's Positive Choice center, which is part of a service I can employ after surgery for help with my nutritional needs.  I just have been feeling weak and lightheaded.  I wanted to make sure that I was doing the right things for my body with the increased exercise.  When I work out, I'm burning about 900-1100 calories a day with just exercise.  Given I was eating 800 calories a day, it makes so much sense that I was feeling the way I was.  The dietician told me that 800 calories a day is just not enough for a person that exercises as vigorously as I am.  He did a mathematical calculation based on how many calories are in protein and what I was taking in each day.  He told me to increase my calories to 1200 per day instead of the 800 my bariatric surgeon recommended.  He understands where the doctor was coming from, but we do need to take into account how much I'm burning during workouts.  When I asked him how I should increase the calories, he said it is as simple as making sure I'm getting enough healthy fats in my diet such as coconut oil or almond butter.  He also told me I need to take in 100 grams of protein per day now with the increased calories and to ensure I am hydrating enough.  He stated that I should try to get in as many fluids as possible earlier in the day but to shoot for at least eight cups.  He also agreed that the strength training I'm getting with my trainer is especially valuable in dealing with excess skin and having a toned body because we can lose a lot of muscle mass with significant weight loss if we are not also incorporating strength training.

So, my friends, I'm working it and taking good care of myself.  It's a long time coming, that's for sure.

Constipation woes and shocking other people

One of the issues people have to deal with that have bariatric surgery is constipation.  I know that I have to use aids to help me because things just don't "flow" correctly (I seriously am trying not to be vulgar).  What works for me is that I stay regular when I drink one cap full of Miralax with a beverage in the evenings.  As long as I do that religiously, then I have no problems.

Well guess who has not done that religiously?  I know, hanging my head in shame.  Now it's uncomfortable to sit.  I have been drinking more to get things moving again, but it may take a day or two to catch up.

Not to place blame, but I have been preoccupied.  Since I started dating or preparing to do so, I seem almost addicted to it.  It's a strange feeling.  I can acquaint it to a young teenage girl getting excited about meeting a boy she's interested in and everything becomes about that boy.  I'm experiencing the same thing, but as a 42-year-old woman.  I have the butterflies in my tummy.  It just amazes me how much I think about him and what possibilities lie in front of me.  It's not even just with him but dating in general.  When you're an obese or overweight person, this part of life often times feels like it is not attainable for you, as if everyone else is in on a secret you are just not privy to.  Yet, here I am, right in the thick of it, feeling beautiful and worthy.  I pray we should all feel that way.  We all deserve to feel that way.

Today my mother came over for a visit and she hasn't seen me in about a month.  She has a key to my house so she came in while I was in the restroom.  When I walked into the room, her jaw just dropped.  She said the weight difference is incredibly noticeable.  When you look at me, you can clearly see it in my jawline and around my hands.  It's the little things that become noticeable, like collarbones and seeing actual wrists.  I know you guys know what I'm talking about.  These non-scale victories are huge.  I did tell her about the new guy in my life and that she should not be using that key unless she gets my permission to enter beforehand, for obvious reasons.  She blushed when I told her that.  I did admit he is younger and she was trying to guess how much younger and she wanted me to show her pictures.  In time I will share with her the details, but for right now we are having fun and I don't want things to dampen that.  There definitely is an age difference, but I don't want others (including myself) judging the situation unfairly.  Besides, he pursued me, not the other way around.

Anyway, here I am trying to be a better blogger!  Off to bed I must go.

Weekly weigh-in

During the last week, I lost 3.4 pounds.  My doctor did warn me that I will drop weight very fast the first 10 days or so after surgery and then it will slow way down.  He was right!  I dropped 21 pounds in less than two weeks, and then it seemed to halt fast.  I'm not going to let a slower loss this week frustrate me because I know my body has gone through some major trauma with the surgery.  I'm getting in less than 700 calories a day, so I know it's not as if I'm overeating.  I wish I could get more calories in right now, but my little pouch does not allow me to eat more than I'm already eating while staying on soft foods.  Even my dinner was a little bigger than I've been having and it was 120 calories.  I had one ounce of tiny shrimp, one light Laughing Cow wedge and three ounces of split pea soup.  Believe it or not, it made me full.  It's such a different world for me now.  Some people have stated that their desire for food has gone away with the surgery.  Mine has not.  I see sweets or other delectable looking things and I still want it.  Yet, I just can't go there.  Even if my pouch allowed me to eat ice cream, there's no protein in there and that's what I'm surviving on right now.  Besides, when has there ever been enough ice cream, pie or cake for me in the world?  In time, I know I'll be able to eat more than I do now.  The truth is that I'm learning a new way of eating so I'm trying to be patient and gentle on my body.  One of my friends from the Kaiser pre-op program has landed back in the hospital after surgery due to some complications.  While I am praying for her healing, I also need to remind myself that I can also develop complications if I don't everything I must to take care of myself.  That means getting in all my protein, drinking enough water and not pushing my body beyond it's limits.  Sometimes this means I need to rest when I don't want to or staying on a schedule to meet all my nutritional needs.  There's absolutely no room in there for ice cream!

Dumping and a compression belt

One of the things I always vowed when I started writing this blog was to keep things real.  I wanted to write about a journey that, while it was my own, was an honest glimpse into my life as an obese person (technically "super morbidly obese") trying her best to become a healthy person.  Sometimes the days are wonderful and beautiful with rainbows and kitties.  Other times it might include depression or bodily functions polite people don't always talk about.

Well, I'm about to become very impolite.  My fifth grade teacher, Mrs. Reynolds, would not be very pleased.  Sorry, Mrs. Reynolds, but I just have to go there.

Yesterday marked two weeks that I had my rebirth and underwent gastric bypass surgery.  I have a new tiny little pouch in my body.  I call her Katrina.  That name is the amalgamation of all the ways people have messed up my first name over the years.  (My legal first name is Kathryn, although I go by Kathy or Kath, even Kat.  People have called me Katty, Katie, Kristin, Christine, Katrina.  Seriously, how hard is Kathy?  Anyway, I'm deviating.)  I have been adjusting well to Katrina, but it has not been the easiest thing in the world.

There is a phenomenon that people who have had a gastric bypass go through called dumping.  As I understand it, dumping occurs when you've had something to eat and instead of your body digesting this food, it dumps right into your small intestines.  This occurs because perhaps the item you had contained too much starch, sugar or it just didn't agree with your system.  Some of the symptoms that come along with this include nausea, cramping, vomiting, and diarrhea.

I'm always a little fearful of experiencing dumping.  I mean, it doesn't sound pleasant, does it?  I have had two episodes that might fit into this category.  First, I drank a protein shake pretty quickly.  I didn't down it or anything, but I just sipped it consistently until it was gone.  My doctor warned me not to drink protein too fast, but it's hard to remember all the rules when you're new to all of this.  I had my Premiere Protein shake in about 30 minutes.  Maybe that's normal for a person with a full-sized stomach, but I have a little pouch now.  It made me practically run to the bathroom.  I didn't vomit but something equally as unpleasant.  Your imagination right now is spot on.  The second episode was when I think I had too much to eat.  It's not that I was eating a lot because, frankly, I can't eat that much.  However, one extra bite is enough to send pouches like mine to dumping.  After I had a particular meal, I was burping consistently for quite some time and my tummy felt like I had a stomach ache.

Oh the adventures of my life!  I know this is temporary and it will pass.  I am having a positive attitude about everything because what else can I do?  Already it looks like my diabetes is in remission and that right there makes me very grateful.  The weight is dripping off my body pretty quickly and so I'm just hanging on for the ride.  I am experiencing pain on my left side under one of my incisions, so I know I can't resume normal activities yet.  I went walking the other day and decided to go for more than ten minutes.  All of a sudden, the pain came on and it was pretty unbearable.  I walked very slow so that I could get back home in minimal pain.  I put on my compression belt to help keep everything tightly in.

As you can imagine, it's hot when I have it on.  While it feels good for awhile, I have to take it off to breathe comfortably.  I know things will get better in time, but for now I tire pretty easily and that pain reminds me that I can't return to normal life quite yet.  It is still there on the left side, so I know it will take time.  I'm on sick leave from work for six weeks, but oh my Lord am I bored.  I've been reading books, watching crazy daytime TV, playing Candy Crush and trying to exercise when I can.  Recovery takes time and I need to always remember that.  Just because my incisions don't look like much looking at them from the outside, a lot of twists and turns did occur inside my body.

Are you okay, Kat?

I know it's time for a major update!  After a three night stay in the hospital following my surgery, I was discharged to go home yesterday morning.  Thankfully my doctor did his rounds nice and early so I was able to leave there by 10:20 a.m.  He reviewed my list of medications with me.  Because my blood sugar numbers ended up great in the hospital, I have already been taken off my diabetes oral medication and injected insulin.  I'm still monitoring my blood sugar levels to turn in when I visit my primary care doctor in about 3 weeks, but things look great.  My blood pressure medicine has also been cut in half.  For so early after the surgery, this has been incredibly encouraging.  Some new meds were added, but that was to be expected due to the malabsorptive nature of the surgery.

My post-op care included all of the following until I meet with the doctor on Tuesday for a follow-up appointment:

• Continue on a clear liquid diet through Tuesday evening, limited to water, Crystal Light, broth, Popsicles, Diet Snapple, and Gatorade Zero.  Must drink a minimum of 30 ounces per day with no more than 2-3 ounces per hour.
• On Wednesday, add in one pre-made or powdered protein shake with about 30 grams of protein.  Continue with the clear liquids, but do not add more than the one protein shake until meeting with the doctor next week.
• Begin taking medications, dosages indicated by the doctor on Tuesday.  However, because I may only sip my liquids, I must take only one per hour.  This means I have to space meds out through the entire day.
• Walk frequently to prevent blot clots from forming.
• No driving a car until cleared by the doctor and no longer taking pain medication.
• No lifting 15 pounds or more.

While I was in the hospital, I was a walking champ.  I wasn't trying to be Miss Overachiever (no, seriously!) but I ended up that way.  On my last full day there, I did 42 laps around that floor of the hospital, complete with my rolling IV cart.  I was donning a tshirt, sweats and every chord known to man in the medical world hooked up to my heart, chest, tummy, wrist and more.  It was a real challenge to even go to the bathroom, but I rocked it.  I was just feeling so good ... that was until I walked outside of the hospital.  My mom and one of my friends were there to take me home, but first we all decided to walk across the street to the doctor's office to pick up some paperwork for my mom.  She is staying with me for two weeks to take care of me and she needed some FMLA paperwork signed by the doctor.  We looked on my phone and the distance to the doctor's office from the hospital was 14 feet so I thought it would be fine.  What I forgot was that the floor in the hospital was indoors, an even platform with no steps and a very controlled environment.  Walking across the street to the doc's office winded me by the time we got back.

On the ride home, I forgot the suggestion so many people had given me to be sure to bring a pillow to put over my tummy so it would be a less painful experience getting home.  Let me tell you, I felt every single bump.  My friend was driving the car and she missed an exit so she jerked the car to the left and that pulled at my seat belt.  I'm sure you can just imagine the pain I felt in that moment!  Thankfully the seat belt was not laying directly on any of the incisions, but it hurt no matter what.

Finally, when I got home, I just laid with my kitties on my own bed.  Ahhh ... it was such a nice feeling to be outside of that hospital.  Now, it seemed for the time being, the biggest challenge for me was to continue to sip my drinks and pick up prescriptions from the pharmacy ordered by the doctor.  I must have either drank some water too fast or drank too much of it because when I was in the middle of the pharmacy, I almost threw up.  Seriously, right there while I was talking to the pharmacist.  I'm not even mentioning the gas pains, which were horrible because of all the gas they pump into your body during the surgery.  At times, I felt like I couldn't breathe or I would have sharp pains on my sides.  The nurses assured me those were gas pains.  It was incredibly uncomfortable.

When it was time for me to take a shower, I went into my bathroom, took off all my clothes and then looked at myself in the mirror.  I have five tiny incisions on my tummy as well as some bruising.  It's not bad overall, but they are definitely reminders of some major work being done inside my body.  In that moment, I got so emotional.  I got under the water in the shower, let the drops run over my head and then I just wept in the corner.  I thought to myself, "My God, I can never take another sip of anything without possibly throwing up," coupled with, "You know you did this, don't you Kathy?  If your eating wasn't so out of control, you wouldn't have resorted to major surgery where they rearrange your freaking intestines in order for you to lose weight and maybe have a normal life."

Now, please understand, these are not my true feelings.  The enormity of everything just got to me.  I can never eat like I did before without hurting myself.  I have a lovely new tool that will help me have a healthy, good quality of life.  In the process, though, there will be mourning.  I don't regret this surgery, but it is an adjustment that I just can't adequately describe.  It's not an easier path by any means, but it's one that's designed to help me and I have to be willing to accept that help, even if it's not on my terms.

Since I had that shower, things have been feeling good.  I do have some pain, but it's pretty manageable.  Having my mom with me has been wonderful, but every time I start coughing or take a moment to breathe deeply because I'm feeling pain or burping rises up, she asks, "Are you okay, Kat?"  I'm talking every single time.  Every one.  I have explained to her that there will be times that I will cough and it will sound bad.  I might even throw up or feel like I'm having a heart attack.  That's my body's way of telling me it doesn't like something.  As a case in point, I was having a Popsicle earlier today and I put too much of it in my mouth to swallow before it melted all over my fingers.  My pouch didn't like that at all, so I could feel a sort of bubble sensation in my chest and I started coughing violently.  I even excused myself from the room so I could do my hacking in the bathroom.  "Are you okay, Kat?"  Of course she says it out of love and concern, but she doesn't understand the logistics of the surgery very much so she's asking me that question any time I make a peep out of my body that doesn't seem to be normal to her.  I am reminding myself, though, that even though she doesn't understand the surgery, she loves me and doesn't want me in any sort of pain.

Tomorrow is another new day with a fresh start.  And a fresh batch of one ounce cups to at least get in my 30 ounces for the day.  I am having five friends coming to visit tomorrow at different times, so I'm looking forward to that so much.  I'm sure I'll be lifting my shirt a lot to show them my tummy with the incisions and bruises.  Never before in my life have I showed so many people my tummy and not blinked twice about it.  It reminds me of those women who get breast implants put in and want to show everyone their new boobs.  So proud!

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.

How things are going after surgery

Hi everyone!  I'm in the hospital right now, writing this post through the Blogger app on my phone so we'll see how it goes.

The day of surgery on Friday, I was feeling calm as I got up at 3:15 a.m. to get ready.  It was so surreal that after months and months of preparation, the day was finally here.  My mom was asleep in my guest room, so I tried to shower quietly until I needed to wake her up to do the same. In those moments alone, it was feeling like a rebirth to me in some ways.  I scrubbed my body thoroughly, as per the surgeon's instructions, and it was like I was washing away the parts that I could let go of - the person who was a slave to food, whose body was breaking down day by day.  It actually was a very cleansing shower.

I had a great medical team working on me.  They did a great job of checking on me to see how I was doing prior to surgery and easing me into anesthesia.  The surgery took three hours, but apparently I did a really good job.  I woke up in recovery in sooo much pain though.  My back felt like it was on blazing fire.  Thank God my mother was able to do deep tissue massages on me.  In fact, if she wasn't there, I would have probably been in tears from all the pain.  She kept me very strong.  They also put a lot of gas into my body so that made things feel heavy and painful.  Despite all that, I was able to push through the pain, knowing God was watching over me and holding my hand through the entire process.

Day number two was amazing!  The pain was nowhere near as strong and it felt like a night and day difference.  I walked around the hospital floor 19 times, which is the equivalent of over a mile.  The nurses told me I was the first person ever to be excited to begin walking ... they usually have to tell people to start walking. I was allowed to walk at 4pm the day of surgery and boy was I chomping at the bit!  I am in pain right now, but I'm pushing through and happily pressing my pain pump.  Meanwhile, I am able to have an ounce of ice chips every hour.  Tomorrow I will be allowed to take a shower and have liquids.  

I have a lot of gratitude and praise God all the way through.  I know I'll feel better as the days continue to pass.

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.

Biopsy results and following the rules

I received a call from my dermatologist today with the results of the two biopsies done from my foot.  I am happy to report the areas in question were benign, so the cancer has not returned.  Hallelujah!  I do have a lot of pain in my foot, but there was a deep sample taken so I know it will feel better soon.  I'm trying to stay off of it as much as possible.  It's hard for me because I'm recording really low numbers on my Fitbit.  I try to aim for 10,000 steps a day most of the time and right now I'm at 1,347 steps for the day at almost 11 p.m.  Ho hum.  It will get better, though.  In the meantime I need to just practice patience.

Since seeing the surgeon the other day, I've been kicking things into high gear in terms of following the instructions given to me in preparation for surgery.  I decided when I got home and starting tearing in to all of the reading material that I need to do everything I can to have the right mind-set going into surgery and to prepare my body.  While I will be having the gastric bypass done laparascopically, it is major surgery internally.  Anything I can do to make the surgery easier on me and on the surgical team is what I aim to do.  If I was able to stay on Optifast and no "regular" food for eight or nine months, I can do this, too.  The surgical materials talked about some changes I can make, if I have not already started, to help decrease the risk of death, pulmonary emboli, wound infection, pneumonia and other complications.  Of course that is all very serious.  Some of the very important things I pulled from the reading include:

• Begin exercising now.  Walking at least 30 minutes to 1 hour daily at a brisk pace will help strengthen your heart and lungs for surgery.  Daily exercises to strengthen and build muscles will help you during your recovery.
• Deep breathing exercises two times per day enhances lung capacity in preparation for general anesthesia.
• Begin a multivitamin and mineral supplement daily.
• Take 1,000 mg of vitamin C per day.  This will strengthen the immune system and aid the healing process.
• Increase protein intake by adding a high protein bar or high protein drink once or twice a day as a meal replacement.  This will promote muscle formation and allow your body to begin weight loss by burning fat.
• Increase your daily water intake to include a glass of water with each meal.  Tea and coffee do not count.
• Eliminate caffeine.  Waiting until the time of hospitalization may cause withdrawal symptoms.  Caffeine is also found in most sodas, chocolate and tea.  These should be eliminated from your diet.
• Eliminate sodas and carbonated beverages.
• Begin a high-protein, low-fat, low-carb diet.  Eliminate bread and pasta to help shrink your liver for surgery.
• Begin lifestyle changes and prepare for success:
• Schedule routine eating times and only eat in designated areas.
• Avoid eating while doing other activities.
• Use a cocktail fork or child-size flatware along with a small plate to help reduce portions.
• Practice leaving food on your plate at the end of the meal.
• Go to a bariatric support group.
• Make sure you continue losing weight otherwise your surgery may be cancelled.

My healthy low-fat, low-carb
dinner ... delish!

Whew, what a list.  Obviously this is for my benefit to ensure I have not only a successful surgery and recovery but healthy life afterwards.  Thankfully I have already started incorporating most of these suggestions.  If you're on MyFitnessPal with me, you'll even see my meals have been including protein meal replacement drinks and I'm continuing to do that.  When I made my dinner tonight, I decided to turn off the TV and the computer so that I could focus on my meal.  The only thing I had on in the background was meditation-type music from Pandora.  It was an interesting experience.  I easily have forgotten how mindless eating can be when I'm doing it for the wrong reasons.  Eating when I'm bored, tired or watching TV is very different than when I am doing it for nourishment.  

Clearly I want to do the very best I can to be successful.  There have been so many attempts to lose weight in my life and I don't want this surgery to be in vain.  If I go in with a positive attitude and doing everything that I can on my end, it won't be.  I know it is a tool and that I will need to do a lot of work, but I am honoring myself in this process as much as possible.  I have to be honest with myself when it comes to my triggers and emotions around food.  In one of the gastric bypass groups I belong to on Facebook, someone asked what people did for their "final meal" before surgery.  Reading what people wrote was so shocking to me because most went all out.  If I go all out, I know myself well enough to admit that there is no stopping point, especially if I rationalize it will be the last time I could have something for a very long time or maybe forever.  I'm the kind of overeater that has no boundaries.  Good Lord, I got up to 420 pounds when I had started Optifast a couple of years ago.  If I had that last meal, it would include every sweet food I could get my hands on and probably send me into a diabetic coma.  I'm not exaggerating on that ... I've had high blood sugar readings before so I know I could do it again.

Instead, I am walking forward with as much peace as possible.  I'm being kind and gentle to my body.  I'm trying my hardest to listen to the doctor and follow his advice.  I certainly don't know what this surgery is going to be like for my body but I do know the pre-op suggestions and rules are for my benefit.  If I can do my part to make sure I don't develop complications and pain, then you know I'm going to do it.  

Dermatologist update and my surgical consultations

I received a phone call from my dermatologist in response to the message I sent him after the biopsy was done the other day.  I just wanted an explanation of what happened from his point of view.  He stated that he first removed the mole that was on my foot and put it in the container full of liquid, as is the normal process when biopsies are completed.  Upon visual inspection of that mole, he thought it did not appear as dark as it had before removing it.  He looked back at my foot.  At this point, it was swollen because he had already injected the numbing agent.  He did, however, notice the pigment was a little darker in an adjacent area.  He said the skin tone of a darker person is atypical, but there was a color change so he had to be sure since I have a history of melanoma.  One of the things you look for with skin cancer is a change in the color of the skin.  Without talking to me about it, he decided to take a sample of that second area.  He said he had to cut deeper because there was a little bit of a callous on my toe.  He chose not to tell me before he went in for the second sample because he did not want to alarm me or my friend.  He apologized for how things transpired and for the insufficient bandaging.  He said he had thought about it all night and was very concerned.  He gave me his personal desk number at Kaiser and said to reach out to him directly if I have problems with healing.  I expressed to him my appreciation for his apology but also explained to him that if only he had told me he was going in for the second sample, all of this anger and confusion could have been avoided.  He understood and apologized again.  

Do I believe him?  My gut says yes, but I need to sit with this before I decide if I want to do anything further.  The pain in my foot was pretty bad yesterday but at least I can step down on it today.  I do have a lot of gauze wrapped around it to help cushion the area as much as possible and I'm elevating it quite a bit.  This was not a good experience but at least, for now, it's done.  I should hear back in a few days on the results.

On to better news!  I had all three consultations for my surgery with the psychiatrist, internist and surgeon so I wanted to write about those experiences.  A friend from my pre-op classes offered to take me, which was such an amazing blessing.  Not only did she know exactly where to go, but she dropped me off right in front of the buildings so I wouldn't have to walk too much on my foot.

The first appointment was the psychological evaluation.  This doctor's practice was in a portion of her home.  She was very friendly and that helped me feel at ease.  She wanted to get a feel for my mental state going into surgery, so she asked a series of questions designed to build a report on my present state.  She asked me questions about what it was like for me growing up, what my family dynamic was like then and now, the physical health of my parents, my happiness level and my support system, among other things.  She did have me elaborate quite a bit on some areas, such as being teased in school and how that impacted my self-esteem or some of the details about when I was raped as a teen.  It was a nicely flowing conversation and she said she felt no pause in recommending me to move forward.

We finished early and decided to head over to the second appointment, which was with the internist. That was a good call because he took me in practically right away.  I was weighed and my height was measured before I went back into the examination room.  I had gained weight since the classes ended and I'm working to get it off, but it was disappointing.  However, I had to just say to myself, "Okay, this is where you're at and just move on from here."  It is what it is and everything happens for a reason.  Once in the room, the nurse had me remove my shirt and bra and then put on a hospital gown with the opening in the back.  She then performed an EKG to ensure my heart was healthy for surgery.  The doctor then came in to review those results and went over some of my responses from the questionnaire I completed back in May.  He said my heart looked really good and he has no pause whatsoever to recommend me for surgery.  In fact, he told me that I am the exact person this surgery was designed for.  After surgery, my diabetes will most likely go right into remission and my sleep apnea will be significantly improved if not gone altogether.  Most of the medication I am taking I will no longer need to take and the pain I feel in my body will most likely get significantly better in time.  It was an incredibly positive experience.

The last appointment was with the surgeon I chose in the Pacific Bariatric group to perform my surgery.  All of the surgeons have a great reputation since this facility is a center of excellence, but I have spoken with several people who actually had this particular surgeon and they raved about him.  Beyond that, I felt a connection with him after attending an information session where he spoke.  They weighed me again and measured my height using the Tanita Body Composition Analyzer.  It actually gave me a print-out of my stats.  My BMI is currently 51.3 and my body fat percentage is 52.1.  That was pretty sobering but I also reminded myself that the reason I am here is to do something about it.  I can only imagine how different things are going to look in a year from now.  I was given a CD with a lot of information to read about preparing for the surgery and what things will look like post-op.  The doctor was very kind with me and answered absolutely every question I had.  He also said I was an excellent candidate for this surgery.  He did do a physical exam where he listened to my heart and lungs while also looking at my abdominal region.  He took his finger and showed me on my skin where the five incisions would be since I'll be having my operation done laparoscopically.  In terms of the next step, he talked to me about my vitamin, eating and exercising regimen.  He said the most important thing from now until surgery is that I work on doing things to shrink my liver as much as possible to prevent problems during the surgery.  So he wants to make sure I'm replacing 1 or 2 of my meals with protein shakes and that I stop eating bread, pasta and sweets because the carbs effect the liver.  He did tell me that all three doctors, including himself, would be filing their reports that evening and then I should be receiving a call from their scheduler to pick a surgery date within a few days, but no longer than a week.  A couple of my classmates did not have a positive experience in their consultations with this surgeon yesterday after my appointment, but mine was highly positive and I like him.  I pray the best for them but I feel very comfortable with him and completely satisfied that I chose him as my surgeon.

My friend and I went to lunch after that.  We talked about the fact that this is feeling very real now.  It was one thing to go through the six months of pre-op classes, but being seen by the doctors elevated all of that.  It is very likely that I will be having this surgery before this month ends.  Eeeek!  That is so surreal to me.  I have been working on this since November so it has not been quick at all but I feel I'm as ready as I'll ever be.  So now I wait for that phone call.  Will I be obsessively checking my phone for any missed calls?  Probably.

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 ;-)

Thinking about that spot and lab results

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

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

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

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

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

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

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

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

Okay, there, I feel better now.

Practicing mindfulness, fitness test and a new spot

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

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

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

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

The idea of mindfulness

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

Mindfulness is a way to pay attention, without judgement, to what is going on in each moment with a a stance of curiosity and compassion.  It is a state of being present in the here and now; being in the moment, being in your body; not being on autopilot.  This sounds simple, but with all the things competing for our attention, being still and quieting the mind, body, and spirit can seem almost impossible.  Creating stillness, calmness, and peace within, is an art to be cultivated and the practice of mindfulness provides the mentoring and guidance to settle down.  When you are creating healthy habits in your life and letting go of those that no longer serve you, Mindfulness is a beautiful way to guide you along your journey.  It is like having a gentle coach instructing you how to achieve your fullest potential with love and compassion.  Mindfulness can do all of the following:

• Reduce stress
• Improve immune function
• Enhance appreciation and gratitude
• Greater acceptance of self and others
• Improve positive decision making
• Calm the mind
• Improve focus and concentration
• Help manage physical and emotional pain
• Create inner peace and feelings of joy
• Reduce reactivity and help us control our responses
• Retrain the brain to think more positively
• Decrease anxiety and depression
• Improve disordered eating habits

As you can imagine, if you've been reading my blog for any period of time, I was glad I was attending this group.  We started out by each one of us saying something we are grateful for right here, now, today.  Then the first exercise was to get us centered and focused on our breathing.  After doing that for a few minutes, we had some discussion then went into a second exercise.  This one was about total body relaxation and letting go.  I closed my eyes as the therapist guided us through an absolutely phenomenal experience.  She had us focus on parts of our bodies and move them or feel them mentally ... feel your feet planted on the floor in your shoes and now wiggle your toes, feel the bones in your ankles and how they support your legs, on up until we reached our heads.  She then had us take the parts of our bodies that were full of tension or pain and let that tension and pain go in our minds while we focused on the in and out breathing of our bodies.  As we continued to listen to her instruction and focused on our breathing, she had us each think about someone we wanted to offer compassion and think positive thoughts for them.  We thought about their happiness, peace and love.  Then she turned it around and told us to now take those feelings of compassion and bring them back inward toward ourselves, without judgement, but pure love, just as we would extend for another human being.  

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

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

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

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.

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??

Finished my pre-op classes and weekly-weigh in

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

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

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

Pre-op class #23, weekly weigh-in and returning to just a little work

One more pre-op class to go for my weight loss surgery... eeek!  This is getting really intense.  So here's what's left of my process:

1. Attend the last pre-op class next week.  During that time, the facilitator will determine if I need to go back and see the doctor who originally approved me for surgery if I have not lost within ten pounds of my ten percent goal.  As it looks like right now, I will probably have to do that.
2. The facilitator will send my paperwork down to Kaiser's Positive Choice clinic to their director, who will contact me to see the doctor.
3. After I have seen that doctor, I will be instructed to do lab work where they will be drawing blood to run tests.
4. Once the test results are in, I will then need to participate in an ambulatory test to ensure I am able to walk.  This consists of walking around an office building five times at my own pace.  That is a cinch ... I just walked ten miles a couple of days ago so I think I'm good.
5. The next step is to schedule an appointment to meet with three doctors at Pacific Bariatric where they will be performing the surgery:  psychiatrist, internist and surgeon. When I meet with the surgeon, my surgery will be scheduled.

At this point, it looks like the surgery will be happening in September.  I'm a little disappointed with that since I'm not really working during the summer and it would have been great to do it now.  However, I understand it is what it is so I will need to contact the director of my master's program and let him know I won't be able to start classes with my cohort in September.  That's certainly not the worst thing in the world.  I was just anxious to get going on the classes but it's not as if it's going anywhere.  I will have to determine how much time to take off of work when the time is right.  The surgeon prefers that we take six weeks off to give our bodies the best chance to recover.  We can return to work sooner if we feel up to it, but he does expect us all to take the six weeks if possible.  My principal, administrator and quite a few others at work know I am going to have surgery and have been super supportive.  I have well over a thousand sick hours on the books, so it's not as if I don't have the time.  It's just hard for me, especially working in a busy high school, to take that much time off, even if deemed medically necessary.  It's probably my work ethic ... I just don't want to let anyone down.  I do believe they can get a sub in and I know a great one so it is possible that life goes on without me.  Letting go is so hard when you like to have control of things.  

Speaking of my class, I lost a couple of pounds this week so I'm happy about that.  Steadily going down is great.  This week we talked about ways of coping with stress instead of eating.  Here are some suggestions as given to us in class:

• Learn to say no.
• Listen to my body.
• Let go of what is not working.
• Accept myself as is.
• Say yes to feeling good.
• Find time each day to be a lone.
• Simplify my life.
• Talk about or write out what's worrying me.
• Take time to be touched.
• Develop a sense of humor.

Something that really struck a chord with me was this:  I must be willing to leave those parts of my life that no longer serve me.

Do you have those moments when you're in a room full of people but then you read something or hear something that makes you feel like you're all alone with God and everyone else is tuned out, even for just a brief moment?  That was what I felt when I read that.  When I was a kid, I was physically abused for a very long time and raped when I was a teenager.  Unless you've been the victim of those things, it's hard to articulate the feelings you go through, especially as a child.  You feel lost, abandoned and very, very small.  I didn't run to anyone and tell what was going on.  Instead, what I did was I hid inside myself and I ate food.  Food was my escape, my solace in a world I couldn't quite understand.  Food let me not feel pain and somehow made things better in the moment.  

As an adult, I no longer am abused and no longer surround myself with people that can hurt me.  Every person in my life today is there because I have chosen them to be there.  I'm no longer having those feelings of loss, terror or abandonment.  So the food no longer has to be a solace and I can let go of this need to run to it when I'm feeling some sort of emotion I am uncomfortable with.  When I'm bored, I really don't have to go eat something to fill up that moment.  When I come home from work, I really don't have to head straight to the kitchen.  Food no longer has the role it once did in my life.  Especially as I head into surgery, I must leave the part of my life that no longer serves me.  I know it's easier said than done, for many of us, but it takes practice.  That's what my program's facilitator reminded me of tonight ... these things will take time and practice.

Tomorrow I'm going to return to work for just a few days to sub for a co-worker.  She is on a 12-month contract, so I'm coming in while she spends some time with family coming from out of town.  Knowing I wouldn't have as much time to play this week as normal (I know, you are hating me right now, aren't you??), I went with a friend down to Seaport Village today here in San Diego.  Here are some pics of our adventures. FYI, even when there is June gloom going on in the weather, always wear suntan lotion.  Always.  Just sayin'.

 

Pre-op class #22, weekly weigh-in and my vacation

I really need to kick it up on my blog posting.  With so much going on in the next few months, I'm going to need the outlet more than ever.  Let's see, I had my 22nd pre-op class this past Monday.  I lost a pound.  Is that even newsworthy?  Okay, I know ... a pound is a pound.  It is making me work out more this week though.  I was really disappointed with the number but I gained before that so I will choose to be grateful for the loss.

The class was a pretty intense one.  Of course, when are they not intense lately?  The topic was on creating a healthy lifestyle.  While I was not crazy about six months of pre-op classes when I started this process towards bariatric surgery, I can say that I am so glad for it now.  We talk about so much more than just the semantics of the surgery itself.  While it's important to know what we will be going through and how to best take care of our bodies before and after surgery, I find dealing with the emotional aspects much more valuable to me.  I can research until I'm blue in the face about the gastric bypass or vertical sleeve, but how am I going to incorporate emotional positivity into my life?  How will I know I am on track for success?

Thankfully I have already started incorporating healthy choices into my lifestyle now.  In fact, as I sit here at my dining room table and write, I am cooling down from a very sweaty workout.  I'm actually sitting here in baggy sweat pants and a loose t-shirt, thank you very much :)  That feels really good.  I've logged all of my food in for the day into MyFitnessPal.  I'm checking my blood sugar to make sure it is in the appropriate range.  These are all things I do for myself now that I can continue doing after the surgery as well.  One of the things discussed in the class this week was about expecting to succeed.  That is such an important thing for me to remember because a great concern I have is, "What if I have the surgery and then fail?"  The point I need to always remember is that I don't have to fear failure if I approach it with the mindset that I will succeed.  And why will I succeed?  Well, because I am putting in the work.  These results come from work, not osmosis.

A very difficult question that came up in class was, "How will I deal with guilt, shame and self-recrimination?"  I wrote down some things that our facilitator shared with us that I'd like to share with all of you:

Self-compassion:  being mindful rather than obsessing over personal weaknesses or imperfections.  This is recognizing you're like everyone else ... you're not unique.  Being kind rather than judgmental.  Talk to yourself as you would a beloved friend.

I shared with the group that I find this to be the biggest challenge of my life and one that I will need to constantly work on.  I am always so self critical.  I try to catch myself in the moment, but really that's easier said than done.  I'll be looking in the mirror, feeling really good about myself, and then everything goes to hell in a hand basket when I put on some clothes that don't cover up my arms.  In a matter of seconds, my good mood is blown and I'm feeling awful about myself.  I know I'm not alone in these feelings; many people feel the same way about themselves.  My challenge, though, is that I need to find a way of being in the moment without choosing to eat over these uncomfortable feelings.  Sitting in it is not a pleasant thought.  I've spent my whole life running away from uncomfortable feelings and now, especially after the surgery, I won't be able to run any longer.

Whew, that's all really heavy stuff!  I've been on summer vacation for over a week now and I love it.  It's amazing how quickly I have forgotten about work and am in relaxation mode.  In my summer of rediscovering my beautiful San Diego, I visited Balboa Park yesterday with a friend.  Balboa Park is a huge urban park with quite a few museums and well as other points of interest.  There is a lot to see and do there.  If you are a resident of San Diego county, some of the museums are free on Tuesdays.  So yesterday we went to several of them and just walked around.  We hit the San Diego Automotive Museum, San Diego Air & Space Museum, San Diego Hall of Champions and more.  We were there moving around for five hours. We had a great time and it was all free!  Of course I took some pictures.