Pre-op class #14 and weekly weigh-in

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

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

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

Water Challenge Day 87:  Drank 178 of 174 ounces

Pardon me while I get a little personal

I know this is TMI but I am in pain while I type this to you all because I haven't been able to go boom-boom (my polite way of saying it) in a couple of days.  Sorry for just putting it out there but it's what I need to talk about right now.  If you've been reading my blog for any period of time, you know that I share a lot of the good, bad and ugly on here.  I have to do that if I'm going to be honest, and that is my full intention.  I know I'm not alone with this problem, it's just that I'm uncouth enough to bring it out in the open.  You're welcome ;-)

When I was on Optifast, I had this problem occur almost on a weekly basis.  It was awful, but because I was losing so much weight so fast, I dealt with it.  I wasn't happy about it at the time, but I guess you pick your battles.  I know that a big reason it occurs is because of dietary changes and perhaps not getting in enough nutrients.  When I was doing that program, I was getting in about 500 calories a day.  I was supervised while on it, but it is no wonder that I developed some of the issues that I did.  Now, with my current 1200 calories a day that I'm doing in the pre-op stages of surgery, I find myself not eating enough calories and food groups.  The calorie limit is a suggestion to help us get off the weight, but it is by no means mandated.  What I've noticed, however, is that I have many times when I'm well under 1200 calories.  Sometimes I do go to bed hungry and sometimes I don't feel the best.  I guess, in my head, I need to suffer to lose weight.  Nobody has ever told me that before.  I think it's just something that has been ingrained in my head from other experiences in my life.

In looking at what I'm eating, I do notice that I've been focusing more on protein.  That is a good thing to do, especially with my future weight loss surgery.  That protein will be the most important thing to eat, yet I can't forget other parts of my diet.  And, for some reason, I have been skipping getting all of my supplements in.  These daily supplements are not required, but are good for my overall health.  Going along with that, I sometimes will forget to inject my insulin.  I'm a diabetic and need that insulin, but I've been very lax on taking it.  I know ... I can't do it because my very life depends on it.  I have to improve on that.

I seriously don't know why I've been doing these things, but I'm publicly owning it on here.  I know some of the people who will be reading this and they will absolutely not let me get away with doing these things that negatively impact my health.  I have taken all of my supplements and will inject after I post this message.  I promise!  I'm so glad I have this blog because I can be accountable here.  Thanks for reading and being supportive on my journey to better health.

Water Challenge 60:  Drank 180 of 180 ounces

Alright, much better today

I walked into today knowing that I had let go of my mistakes with snacking on junk last night instead of having a real dinner.  Writing about it on here really helped tremendously.  In fact, when I was walking with Sara today, she mentioned that I'm an open book on here.  I have to agree with her.  I pretty much put it all out there.  For me, this is a real journey to let go of the weight and part of that process is dealing with the emotions that come as a result, otherwise I will continue to use food as a crutch.  So I vowed to myself when I started this blog that I would be as transparent as possible.  I'm not as brave as some other people when they post pics of themselves with just underwear on or just a workout bra and exercise pants on because, personally, I think that's going a bit too far beyond my comfort zone.  Writing, though, releases so much and helps me get down to true feelings.

After walking at the lake, I spent some time working on my backyard.  There are these huge trees right over my house and they shed a lot during the winter, so there were leaves galore.  I managed to fill two big trash bags of just leaves, but it felt good to clear a good portion of it.  My back was hurting from doing all that bending.   The big reason I am pursuing weight loss surgery is to feel healthier.  A contributing factor is the pain I feel all over my body, including my bad back.  I know that having less weight to contend with will really help alleviate much, if not all, of the pain I feel in my back.  I do know my limits and had to stop, even though I saw weeds I could attack.  It was enough work back there.

My dinner was a stir fry in extra virgin olive oil of
turkey sausage, carrots and yellow bell
pepper over quinoa.  Yummo!

I did much better with my meals today, having them at regular intervals.  I weighed and measured every single thing that went into my body, which was great because then I knew exactly what I was consuming with no guessing.  Some people really hate weighing and measuring, feeling like they are on some sort of diet and having negative feelings associated with that.  For me, there is a certain sense of freedom that comes with weighing and measuring in a weird sense.  It lets me know that I am having what I'm supposed to be having for my good health.  That doesn't mean I can't have fabulous food, just an appropriate amount of fabulous food. I tracked everything into MyFitnessPal, including my water consumption.  I had 72 ounces of water, which was good, but I'm trying to aim for about 100 ounces or so a day.

One of the things that was alarming, though, was my blood sugar level.  I made a really awful decision early in the day in regards to that.  When I woke up first thing in the morning, my blood sugar was 275.  Gulp.  I knew it was because of what I did the night before.  When it was time to inject my insulin this morning, instead of my usual six units, I increased it to 30 units. I can already hear you wondering what the heck I was doing, that it's an incredibly dangerous and, frankly, stupid thing to do.  Clearly I was wanting to get it down badly.  After I came home from the walk with Sara, I checked my blood sugar again and it was 170.  I was pretty surprised it wasn't in the normal range yet after having walked almost three miles.  Of course I didn't think about the fact that it went down 105 points.  However, by the time I was ready to make my dinner, I felt extremely shaky and was starting to sweat.  I instinctively knew my blood sugar had gone too low.  Diabetics know their bodies and can usually tell if blood sugar levels are too high or too low. I pulled out my meter to test and it showed me at 61.  Shit!  Hmm Kathy Jean, do you think that perhaps injecting 30 units this morning was the smartest move you've ever made??  I stopped what I was doing to have a piece of bread so that I could get my blood sugar up.  I contemplated just waiting until my dinner was ready but I was so shaky that I worried about using a knife to cut my veggies.  Everything is fine now and I feel good.  I usually have two Glyburide pills with my dinner to help control my blood sugar but I decided to forgo them since I was so low.  Note to self:  do not do that again.  Duh.

The coolest thing!

When I was at Kaiser last night for my Optifast class, I did routine blood tests, which is required of my program every other week.  Since I am diabetic, one of the things they test is my hemoglobin A1C level.  This is the daily average of a person's blood sugar level over 2-3 months.  It is a more accurate analysis of how someone is maintaining control of their blood sugar than the daily meter because it takes all numbers into account since we can go high or low.  Kaiser wants diabetics to aim for a number of less than 7%.  I received results of the test this morning.  As you can see from my graph below, I am now under that number, 6.7 to be exact.  Looking at my history over the last three years, that's almost half of where I have been.  I could never begin to express how much this means to me.  This is something so tangible more than just the numbers on the scale.  It's an incredible gift that I have never experienced since I was first diagnosed with diabetes.  Thank you, God, for this.

So THAT's why I was feeling lightheaded!

I had some sort of epiphany today.  For the last several weeks, I had been feeling lightheaded when I would get up from a sitting position and naturally assumed I wasn't getting in enough water with my Optifast product.  So, as a result, I kicked up my consumption, which was a good thing for me.  Yet, I still was feeling lightheaded and couldn't figure it out.  This week, though, it hit me against the head in a Homer Simpson moment.  Doh!

It wasn't until I stopped working for the summer and increased my exercise that I realized my lightheadedness is because my blood sugar is too low.  I have been walking every day for at least three miles, which is fantastic for me, but exercise naturally lowers your blood sugar.  Since I inject a little insulin every morning and every night, I had to account for the increased exercise.  It's not even just increased exercise, it's a lot of exercise, but I wasn't really paying attention to that until this week.  I was feeling bad, not quite myself, and would test the blood sugar not just when I got up and went to bed, like normal, but at sporadic times as well.  Each time I would test after I had a shake in my tummy, I was actually in the 70-80 range, instead of the normal fasting range of 90-120.  Fasting means nothing in my tummy, so I can't imagine how low I was dipping during the in-between-shake times. 

Having low blood sugar on a routine basis is so weird for me.  I could never have a normal blood sugar level to save my life, except when I injected so much insulin to force the issue and, even then, it wouldn't last very long at all.  And now, here I am, needing to decrease the amount of insulin I'm taking because I'm too low ... again.  What a joy!  This is an immense benefit of the program.  I'm injecting 6 units right now in the morning and at night.  Before going on Optifast, I was injecting 35 units in the morning, 75 units at bedtime, as well as taking a ton of oral medication.  It looks like I'm going to need to decrease the insulin I'm taking to the point where I see that it won't be too far in the future before I'm not taking any insulin at all.  This is reason to be on Optifast indeed, let alone the wonderful weight loss that comes with it.  It has been a dream of mine to one day be off the diabetes medications.  Is it possible this dream is coming true?