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.

The doctor's visit

As I discussed in yesterday's post, I had an appointment today to see a doctor.  At the time when I saw the therapist to talk about a plan of action, she discussed with me the possibility that I have a major depression going on and that my next step would be to meet with the doctor.  At the time, I was feeling good about that but also full of nervousness, too.  This is hard to describe, but when you have your life in a certain mode for a while, you get used to it.  It may not serve you well (if at all), but it's familiar and there's nothing unexpected.  It's sort of like that with weight loss, too - you want to lose the weight so badly yet staying right where you are is comfortable because you know it. 

So I started my day by sleeping in, which I desperately needed.  I shouldn't really say it was sleeping in because I didn't sleep well.  I got up and then ended up going back to bed.  I was meeting one of my friends for lunch before seeing the doctor, so I thought it would be great to keep me at ease.  This particular friend has known me for probably 15-20 years, something like that.  The last time she saw me was in September.  She was on our campus at the high school where I work and she hadn't seen me for several months before that.  In between the visits, I had lost oodles of weight, I had moved offices and straightened my hair that was always curly.  So when she came up to my office, she clearly didn't recognize me and had to look at the name plate on the outside of my door to make sure it was me.  When we were making plans for today, I felt the need to tell her I had gained weight since the last time she saw me.  We've shared a lot over the years of knowing each other through our work and eventual close friendship, yet I felt the need to explain to her about the weight gain, almost as if she would feel differently towards me.  Silly, isn't it?  People who love and care for you will still feel that way, regardless of the weight.  We ended up having a great visit and she told me that I still looked fabulous.  Friends are really the best!

I then went over to the doctor's office.  I actually had a lot of time to spare, so I checked in early and just sat in the lobby.  The nervous nellies were starting to gurgle in my tummy, so I knew having the extra time to just relax was good.  I found an article about Facebook in a magazine before they went public selling their stock (typical doctor's office - the magazine was over a year old).  It was an in-depth analysis of how Facebook became to be what it is, where it's going, etc.  So by the time the doctor called me back into her office, I was so engrossed in what I was reading that the nervousness was gone. 

We began by reviewing my visit with the therapist as well as additional questions this doctor had.  She is a really sweet person and I was glad to be assigned to her caseload.  I knew this was a very clinical visit, so I didn't suppose the questions would be entirely too emotional for me.  Part of my purpose with her was to determine if I did, in fact, have depression and what course of action would we choose for me.   However, when the questions came around to my weight loss, weight gain and how I feel about myself in relation to all of that, the tears came.  There was the analytical part of myself that go so frustrated.  I thought, Geez, are you going to cry at every freaking appointment?  Then the emotional part of me said, So what if you cry?  Obviously there are feelings there and it's really okay to express them.  I was just so overcome with emotion that it took me a little bit to compose myself enough to answer her questions.  She was very compassionate in waiting to let me gather myself and caring in how she guided me.  The weight issues with me go back a very long time, really for my entire life. 

There came a point in her interview with me that most of the talking shifted from me to her.  She explained the various types of depression that people go through, the onset and treatment options.  She told me that based on my symptoms as well as review of my medical records and the visit with me that I am indeed going through a clinical major depression.  I knew I heard her loud and clear today when she said "major".  So we talked about several treatment options, one of which included medication.  She gave me two options.  Both types of medication have the same success rate, but one has a side benefit of helping with chronic pain as well as suppressing appetite.  However, that one is harder to get off of when it comes time to do so in the future.  It will take months for a gradual weaning, otherwise my body will go through withdrawal.  Yet, given both choices, I opted for the one that has the possibility of helping with the pain in my legs.  It will also likely give me lots of energy and help me to get better sleep.  She did tell me that the success rate for these meds helping patients is increased by other factors, such as a regular exercise program but I also have to monitor my blood pressure because it may go up.  She also stressed the importance of individual therapy as well.  I am already set up with that, which will start on Friday, so I'm feeling good about moving forward. 

I begin the new medication tomorrow.  It will start in small doses as I wean off another medication and then will increase in a week.  If you are a person that prays, I just ask that you please include my pain relief in your prayers.  I have been trying to hang in there, but as most to you know, I'm in pain all the time.  I believe so strongly in the power of prayer.  Things have been tough but I'm still here and I'm grateful for that strength to continue to walk through difficulties.  And, yes, I'm still tracking my food, too!

Not pretty but pretty honest

I just realized as I got on my laptop that the last time I posted was four days ago.  Sorry I have been incommunicado.  I had a killer mid-term last night so all my energy had to go to that.  Graduation is in two months for me, so I definitely need to at least pass the classes.  I had been procrastinating on the readings and just not devoting enough time to studying.  Bad Kathy.

This week has been a whirlwind of heavy emotions.  Although I can't go into specifics, this past week at work has been beyond difficult in dealing with the feelings that came up surrounding a near tragedy.  All I can say is that I work with an amazing group of people that make me feel blessed to be there.  We all care about kids so much and I honestly couldn't imagine being in any other line of work.  Speaking of which, I have the entire next week off because of Spring Break.  Well, I have work off but I still have school.  Ain't complaining though!

The other emotions that I have been dealing with is all about me.  I have been really hard on myself, especially in this last week, about how I have been doing since getting off Optifast.  As most of you know who have been following my journey for some time, I was (and still am) having some medical issues.  Some happened while I was on Optifast and stopped as soon as I was done with the products.  I didn't talk in too much detail about the issues I was having while I was on products because, for one, who wants to know the TMI type of details and, two, I was losing a hell of a lot of weight.  190 pounds in something like nine months.  Frankly, if I wasn't having all those medical issues, I would have stayed on the program all the way until I hit goal weight.  God had other plans for me, though.

So what happened instead?  I gained weight.  Most of it had to do with being put on medication that had a lovely side effect of weight gain.  Yeah, I know, great side effect for someone that was trying to lose weight.  That's just swell!  Then, I didn't help anything by not dealing with things very well.  It wasn't just all the medical stuff I was dealing with.  Yes, the physical pain I am in everyday is very difficult to deal with.  Between the unexplained chronic pain in my legs, the back pain, the carpel tunnel and tendinitis in my hands ... well, it's just a lot of pain.  Imagine trying to put exercise on top of that.  It actually makes me feel better, but it never takes the pain away, just takes the edge off, and sometimes it's very difficult during.  In fact, it makes me sweat more because I am doing everything I can to just breathe through it.  Then I add in things like going to school at night while working full time in a stressful (albeit great) job, dealing with a worker's comp system that is essentially calling me a liar at every turn and it's all just too much.  I have not been handling frustrations very well and, as I put on weight because of the medication, I put it on for other reasons, too.  That's not to say I'm not losing.  I actually am and I'm grateful for that.  But it's a very different experience than Optifast.

I didn't talk much about this at the time, but about a month ago, I went and saw a therapist.  I just had been feeling so blue.  Actually, therapy should have been a part of my life prior to this, but it's difficult.  I have been in therapy before, didn't have a good experience and so I didn't go back.  Regardless of the coulda/shoulda/woulda's, I made the decision with the help of a very dear friend to revisit it.  I have insurance so I decided to start down that road first.  I only have $10 co-pays every time I go for an unlimited amount of visits, so why not.  At the time, I wasn't ready to share it here, but I realize I need to, at least for me.

You see, weight loss is not easy (I know, news flash!).  Anyone who says it is does not truly have a weight problem.  It's not just mind over matter.  Sorry, it just isn't.  I was 420 pounds at my highest recorded weight.  There is more there than the love of food.  When I was doing Optifast, the majority of people I have met have had less than 100 pounds to lose.  So, when they got off of the products and then could go about with their lives as if nothing happened, they had a different experience.  For me, the food has been tied in with emotions.  I have always been an emotional eater.  So when I started gaining weight after getting off of the products, I felt like a huge failure.  It's not like you can hide the problem behind closed doors - you wear your weight.  As more weight was coming on, the more I hurt inside.  And I have been all but shunned from people who supported me during that time.  Relationships have definitely changed with some, although strengthened with others.  I can't describe the sacrifices I went through, the time I spent in exercise just to lose the weight.  It did not happen just because I had five shakes a day.  Nope.  It was blood, sweat and tears.  In comparison, though, it was easy compared to this.  

Then, all of a sudden, my clothes started getting tighter.  In my night classes, the desks are tight.  My Wednesday night class has a desk that feels like it's digging into my body and I have red marks on my body after getting out of the desk.  Last night, as I was taking my mid-term, I was sitting in a classroom that I was in last semester.  During that semester, I was able to cross my legs under the desk and fit very comfortably with room to spare.  As I was trying to write two hours worth of essays on Socrates, Marcuse and other philosophers' take on the value of art in society, all I could think about was my legs crossed under a desk then and my tummy now.  I feel shame.  And that's why I went to see a therapist.  Tied in with feeling blue, my feelings about myself after the weight gain, lack of sleep and Lord knows what else, I do not want to be another statistic.  I don't want to be a Negative Nancy on here, either.  Honestly, it's not my intention to do that.  But, we all have good days and bad days. 

So, when I went to see the therapist, it was just a screening appointment to talk about what's going on and then to set forth a plan of action to move forward.  As I was filling out the patient questionnaire, I could feel the tears in my eyes as I realized that I needed to be there.  Why?  Because the questions spoke right to me.  Not all of them, but some of them were right on the mark.  By the time I made it into the therapist's lovely little office, I was in tears in about three minutes.  I realized that all of my feelings, the deepest part of my soul and heart, were being kept inside.  Of course I do talk about things here, but most of us feel things more when we're in front of another person looking into their eyes than in front of our laptops.  I obviously needed to be there and I obviously needed to talk about what was going on because the tears would not stop coming.  The thing that has broken my heart the most was the weight gain.  I was cursing Optifast but I was also counting it as a great blessing to me.  I know, confusing!  I cursed it because it felt like a band-aid with the shakes.  Sure, if I don't eat food and I drink just shakes, of course I'm going to lose weight.  But I felt like I didn't learn what I needed to to be successful in keeping it off.  Yet, at the same time, I was praising it because it gave me a really good jump start.  Although I have gained a lot of weight back, I have not gained as near as much as I think I have.  In my mind, I'm right back where I started but that's just not true.  I still fit behind the steering wheel of my car without the need for a seat belt extension. There is still lots of room to spare.  I am not wearing size 34 pants.  More than that, Optifast gave me a glimpse of what could be.  Even though I was not down to goal weight, I was able to buy clothes in any store and I was starting to feel like a human being.  When you weigh 300, 400 or more pounds, you just don't feel a part of the human race.  At least that's what it felt like for me.  Now I'm much more aware of bigger body parts that I just don't like.  So, anyway, back to the counseling session ....

The therapist asked me questions so I could talk more about certain facets.  Then she said to me, "Kathy, it appears to me that you're going through a major depression."  Now, I don't know if the word "major" was the actual word she used but it could of been some other adjective that closely resembles it.  It might have been "significant" or "serious".  She asked me how I felt about medication.  I was prepared for the possibility of having this conversation.  I told her that I am okay with it, provided it is necessary and it is not used as a crutch to solve a problem.  If I was to go down the road, I would want to do that in conjunction with individual counseling sessions.  I have been struggling with weight my entire life.  If you've looked at my photos link at the top of the page, you'll see a little girl with excess weight from early on.  We discussed some options and I will be seeing a doctor as well as a therapist.  As I walked out of there, I literally felt like the weight of the world had been taken off my shoulders.  I told myself that if I was going to do this, I was really going to do this, leaving no stone unturned.  It does take a bit of waiting to get an appointment, but I finally get to see the doctor on Monday and the therapist on Friday.  I don't feel like I'm ready and, at the same time, I am beyond ready.  There have been some major issues in my life that have contributed to the weight and those very issues helped keep me there for a very long time.

When I originally started this blog, it was about transparency to myself.  I didn't imagine many people would find my little blog, let alone be interested in my journey.  Yet, I do know that I have a story to tell and I am finding the courage to somehow put myself out there.  My story isn't one about getting on Optifast, losing all my weight and then going on with my merry little life.  That's a storybook ending.  Instead, I'm a real person battling through a real fight.  If you know anything about me, you at least know I am a scrappy little fighter, Kick Ass Kathy some have called me.  Geez, after four days of not blogging, now I'm chatty Kathy ;-)

Moving away from the scale

When I was on Optifast and dropping so much weight very quickly, I posted on here how much I was losing (or gaining) each and every weigh-in.  For those of you who have been reading my blog for a while, you'll notice that my page with all of my scale stats is gone.  I still have it, but it's in a hidden folder right now because I realized that I was giving that scale too much power.  It was awesome to jump on that thing when I was losing so much weight.  It told me I was feeling good because who can fight that feeling when things are going well?  I remember the first week I was on Optifast products ... I lost 19 pounds that week.  I know that it was a lot of water weight, but 19 pounds?  For a woman??  Mondays was my weigh-in date at the clinic and I posted that evening so people could see how much I had lost.  People even told me they would wait to see my post before going to bed.  It really was a great time of celebration for me.  Then, when the physical pain I've been going through really took a turn for the worst and I had to be put on medication and had to make a change with my eating plan, it was a horrible experience getting on the scale.  I remember one time when I gained 30 pounds in one week.  I know many of you remember that, too.  All of a sudden, that scale became the most awful thing because it produced feelings in me that no one deserves to feel about themselves.  It didn't matter that the bulk of that weight came on when I was put on steroids.  All I could think in my head is Kathy, you have failed.  So I had to make a change.

After starting WW, I decided that I wasn't going to step on my scale at home as much.  I still have it, but it's in the cabinet under the sink in the bathroom.  I can pull it out when I want, but it's not sitting out as it was before.  And if anything is going on, I don't automatically jump on it for validation, one way or the other.  I quickly realized through the course of my triumphs and difficulties that I need to celebrate non-scale accomplishments more.  That's not to say I'm not going to weigh because, let's face it, it is a tool to tell me if I'm at least headed in the right direction.  But right now, and this is just for me, I cannot put too much focus on a few pounds difference.  That will trigger me to overeat.  When I weigh in at the WW meeting, if it's going down, that's the right direction for me.  My weight loss is not going to be anywhere near as fast as it was on Optifast.  Now it's a steady 1-2 pounds per week.  Here are some tips I have learned to help me with dealing with the scale numbers:

• (For those of you on WW) Don't look at your weigh-in results until after you've left the meeting because you can then be present for what's going on around you instead of focusing on the numbers.
• You have no business comparing yourself against other people.  I have been so guilty of that and it's not fair to me, nor to the other person.  I appreciate that my friends are doing so well and don't want to take any of that happiness away from them.
• Avoid weight-loss goals in terms of time, something like, "I'm going to be a size 12 by the summer."  
• Make sure that you are also looking at inches lost, as that is a very good tool to accurately reflect where you're at.
• The absolute most important reminder for me:  ask yourself what the scale is doing to you.  If I am weighing myself on a daily basis, is it making me crazy or is it helping me stay on track?  Be honest about this!  If it is making you crazy, like it was for me, do something to curb that.  For me it was putting my scale away out of my sight that made me feel relaxed.  

I will continue posting my weight on here, but periodically and not like clockwork before.  I have seen, after everything I've been through, that I have to be very gentle and kind towards myself in regards to that.   Having gained some of my weight back (although not most of it, thank you God) has been very difficult for me.  It has left me in tears more than I have admitted to anyone because I put so much work and sacrifice into taking off the weight to see it coming on again has been like a knife through my heart.  This has been really the most painful time for me, not just physically, which is significant, but emotionally as well.  The weight gain started with the addition of the medications that have side effects of weight gain, getting off of the Optifast products and the frustration I have been feeling with all of the chronic pain I've been going through.  That, in turn, has added more weight to my body.  As a result, I would eat more or inappropriate food to deal with the frustration and it has put me in a cycle that has left me with more and more weight on.

Thankfully now I'm on the downward trend, but I have to work very hard at fighting the urge to pick up the food.  It has been a real fight every freakin day.  It's not a fight I have all day long, but pretty much in the afternoon/evening is when I have the hardest time.  Sometimes it's a battle I win, sometimes not.  Thankfully I have my first appointment with the therapist on Thursday.  I have been trying to stay as positive as I can, but I do have my moments where the frustration gets the better of me.  I suspect that I'm going through a depression of sorts right now.  I've never been depressed before, but then again, I've never had to deal with something like this before where the physical pain has not gotten better.  When I had cancer, it was very painful going through surgery and recovery, but it eventually got better.  This has gotten worse.  Even at my heaviest weight, I never hurt near as much physically as I do now.   In fact, I found myself on webmd earlier today looking at symptoms of depression.  Obviously I'm not going to diagnose myself, but it may explain a lot.  I remember when I first made the appointment and how uncertain I was that seeing a therapist was something I wanted to do.  Now I'm certain it was the right move for me and I look forward to it.  It's pretty amazing how things work out that way, isn't it?  For me it's about facing fears and, when I do, the fear isn't anywhere near as huge as I had made it out to be.  That doesn't mean I'm not incredibly nervous about seeing the therapist because I know that things are going to come out during my appointments that I've kept locked inside of me for a long time.  That scares me, but I also realize that just because you close the door and throw away the key on something doesn't mean it's no longer on the other side of that door.  At some point, the door is going to have to be opened again if I want a fighting chance of moving forward.

Geez, puns aside, this was a heavy post today. Yet, I know that it's okay.  This is what I'm going through right now and I can all but guarantee that someone else out there is going through similar things as well.  So many people have commented to me that I have inspired them in the last year as I have lost weight and by not giving up as I've encountered challenges.  If anything,  now I hope the inspiration can be about standing up and fighting for your life, no matter what obstacles you may be facing.  Sometimes mine feel overwhelming, then I'll meet someone that is worse off than I am.  That's not to say that I am discounting my struggle, but it gives me the courage to stay and fight.  I've always been stubborn ... maybe now that's an asset instead of a defect. 

Before I close, I just want to say thank you to all of you for the support you've given me.  I have changed my blogroll list around a bit to incorporate Optifast blogs with all the others I read, but I appreciate you whether you have been on Optifast, WW, some other weight loss program or are here just to support me in general.  Sometimes when I post something on this blog, I'll hover my mouse over the publish button before I post it.  It's because I share extremely personal things on here and I wonder if I'm going to cross the line if I actually post the things I write about.  Then I remember the original purpose of this blog - to document my journey from 420 pounds down to whatever healthy weight God leads me to.  Sometimes that's a joyful journey and at other times it's incredibly difficult, but it's an honest glimpse into the road I travel.  Thanks for holding my hand and coming with me.