(IM) Patiently waiting for my surgery date

I know that God uses a lot of opportunities to help me learn and grow as a person, even when I'm kicking and screaming.  When I had the consultations on Tuesday, my surgeon told me that I would probably hear back in a few days but no later than a week to schedule the gastric bypass surgery.  Of course I'm antsy, just like every other person that has gone before me.  On Friday, I just couldn't stand waiting one more second.  I doubted they would be ready to schedule by then, but I just had to try.  I'm returning to work on Monday after two months of summer vacation and it would be nice to know something going back.  Unfortunately it's a bit too soon.  I was told that the surgeon is reviewing the internist and psychiatrist reports and then will turn in a slip to the scheduler, who will then be calling me.  They believe it will be by the end of the day on Monday.  If anything, I'm glad the surgeon is being thorough in reviewing the other reports instead of working on automatic and pushing things through.  At least I'll be preoccupied being back at work because, even if I get my date on Monday, I'm still going to have to wait until the actual surgery date.  That means more waiting so at least work will keep my mind busy.

My foot is healing nicely from the biopsies done on Monday.  It has been really hard not pushing myself and just walking through the pain.  Each day has brought more healing and the holes are slowly starting to close up.  I was feeling a little worried because of the cuts since I'm diabetic, but I'm taking good care of it and following doctor's orders.  I still don't know if I'm going to move forward in doing anything more with what happened with the doctor.  On one hand, his explanation seems possible and I did have two biopsy results (from the two cuts).  On the other hand, it just seems fishy.  Up to this point, this doctor has taken very good care of me with the skin cancer and he's done many biopsies on me with no problems.  I suppose the problem with all of this was not telling me what he was doing with the second cut and the poor job on bandaging up the area.  It's getting better, so that coupled with the benign results is the biggest thing right now.  After nine biopsies with the skin cancer and one other type of biopsy done, at least that word doesn't scare me any longer.  I feel like a pro now.

Two for the price of one

I had a biopsy done today and to say it was a negative experience would be an understatement.  I'm going to try to go into as many details as possible so that I can not only share with you what happened but so that I can document what happened.  I don't want to eat over this, hence this is why I'm posting all of this here.

In a previous medical appointment, my primary care physician was doing a foot exam with me and noted that there was a mole near the tip of the big toe on my left foot.  She advised that I follow up with my dermatologist since I have a history of melanoma.  

A friend offered to come with me to the dermatology appointment for moral support.  I thought that would be great since I was feeling a little nervous about this one.  Mind you, I've had quite a few biopsies before from this same doctor.  They are not pleasant, but I knew exactly what to expect.  The doctor would examine the suspicious area and then determine if a biopsy would be advised.  If so, he would call a nurse into the room to assist him.  We asked the doctor if my friend could stay and he stated that he normally had family and friends wait outside the room unless I would like her to stay.  I did tell him that I would prefer she stay, which he seemed to accept.

He had me laying on the table on my right side so that my feet were toward him.  It was incredibly awkward because my head was pointing down into a part of the bed that was lower than the rest.  I took a pillow and folded it in half to give me a little better leverage.  My friend sat on the edge of the bed close to me so that we could chat while the doctor was injecting the Lidocaine and performing the biopsy.  The doctor had plenty of room on his end to perform the proper procedures without any restrictions.  As he injected the numbing agent, I felt pain.  After a little bit, I felt an incredibly extreme amount of pain on my foot as he was cutting into my foot and removing skin.  I mean, it was pain that was beyond what I would have expected.  I anticipated a little pain because the mole was little, but nothing like that.  As my friend was trying to distract me from the pain, I had to stop talking and I inhaled deeply to fight through the discomfort.  She reminded me to breathe because I was trying to keep it all in to avoid feeling the pain.  Then I felt another pain.  It felt like he was digging deeply into me.

The doctor pronounced that he was done and that I handled it well.  They were going to put on a simple band-aid and that's when my friend really chimed in.  From her vantage point, she could see more than I could.  She asked if that one little bandage that was put on would be sufficient.  We were assured it would be.  We were given extra bandages to change the dressing at home and then informed that the visit had ended.  I requested the doctor call me with the results instead of sending them to me through the mail since I have an appointment tomorrow with the surgeon.  He left the room.  I put my flip flop back on, careful to avoid my big toe and then stepped down onto the shoe.  The next thing we knew, there was blood all over it.  I took it off and rinsed it in the sink while my friend went and got  help.  The nurse looked at my foot and there was blood all over my big toe, almost gushing.  She ran to get the doctor to show him what was going on.  

My friend was able to see that the doctor had, in fact, done two incision.  I did make the comment that I had cut the bottom of that toe the other day, but it's clear that he had definitely cut off skin in two separate areas.  The nurse was trying to stop the bleeding and, meanwhile, I didn't know quite what was going on because I couldn't see the bottom of my foot.  My friend took a picture and this is what I finally got to see.

At this stage, the nurse had cleaned up all the blood and we were waiting for more dressing to be put on it.  As you can see from the top of the toe, there is a little skin shaved off where the mole was removed (I'll call that area Section A).  But if you look in more detail at the center of my toe, the doctor had removed a crater of skin and went pretty deeply (I'll call that area Section B).  What my friend and I think happened was that the doctor had started cutting into the skin in Section B and likely realized he was cutting into the wrong area.  Then, we theorize, he went to Section A and performed the biopsy.  My friend even saw him with scissors in his hand at one point, which I don't recall he has ever done before.  We started asking him questions and he basically went into an explanation that sometimes the skin is "nicked" during procedures.  I'm sorry, that's no nick!  He did apologize, but he didn't specify for what.  He also said he was able to get a "broad" sample for further investigation.  I was eventually handed a hand-held mirror so that I could see the bottom of my foot and was utterly shocked at what I saw.  The doctor went into further explanation, utilizing some medical jargon, and then eventually left the room, apologizing as he did so.

We were then left with the nurse who explained to me that she had never worked with this doctor before and was just as upset with what happened as my friend was.  Was I upset?  Frankly, I was a little stunned and wanted to just leave.  The nurse bandaged me up with something stronger and tighter around my toe.  Before ending our time together, she reprinted my visit summary sheet and included information for me to escalate this to the next step if I so choose.  She was incredibly professional.  She was just as dumbfounded as we were as to what the doctor had just done.

As we attempted to leave, the bandage fell off after I walked a few feet.  So we went back to the exam room and a second nurse decided on a different bandaging system.  After three attempts, that one worked the best.  The doctor popped his head in the door and asked if everything was alright for probably the 10th time.  He even had the audacity to attempt to fist-bump me and my friend on one of his visits back in the room.  He probably shook my hand 4 or 5 times and even called me after I got home to see how I was doing and to see if I had any questions.

At that point, not everything had completely registered in my mind.  I had a houseful of guests with my classmates from the pre-op program visiting for a get-together.  They were all so supportive as I recounted my tale, with the help of the friend who sat by my side today.  The biggest concern with this, aside from the fact that he ripped deep skin out of my toe when he shouldn't have, is that I am a diabetic.  One of the things they teach us as diabetics is that the last thing you want is a cut on your foot because some diabetics have a hard time healing.  The lack of ability to heal, provided you are so afflicted, can possibly lead to foot amputation.  Obviously I am concerned because I am an insulin-dependent diabetic.  I don't take cuts on my foot lightly.  And I really don't take cuts on my foot that were done in error lightly at all.  

After all my guests left for the evening and I was attempting to walk on my foot without hobbling, I was met with excruciating pain and the anger finally hit me.  This doctor, whom has performed numerous other biopsies on me before, really fucked up.  I mean, he really, really fucked up.  Excuse my language, but I really can't sugar-coat this.  He made a huge mistake.  An "I'm sorry" is not good enough.  I sat down and wrote him an online message through Kaiser's system, requesting an explanation of why he did what he did.  Regardless of what he says to me, I will be escalating this and filing a formal complaint.  I don't have anything against this doctor, but what he did was absolutely wrong.  I hope everything will be okay in my situation, but what if it is not for the next person that needs a biopsy done from this doctor?  

The good news is that I'm not eating over this.  I'm choosing to take care of myself.  I have consultations with the psychiatrist, internist and surgeon tomorrow.  One of my friends has offered to take me and I graciously accepted her offer.  It will help me with not having to walk as far on my bad foot and, really, the moral support is just what I need.  Ugh, what a freaking day!

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.

Staycation in Southern California

I haven't heard back from my dermatologist's office yet on the results of the biopsies I had done on Monday.  No news is good news I suppose.  I did have a little bit of a scare because I received a call from Kaiser on Wednesday.  As soon as I saw the name splashed across my cell phone, my heart immediately started beating faster.  I had nothing to worry about, though ... it was just a routine call from my primary care doctor's office.  Whew!

I have been enjoying my summer so far, though.  It's funny how quickly I forgot about work.  I do periodically check my email for important messages because there's a few things going on that I can't neglect over the summer but other than that I'm pretty free.  I will be subbing for our principal's assistant for three days next month, but I'm not taking classes or trips over this summer so I'm really in relaxation mode.  I do want to work on some projects around my house, but primarily I want to focus the most on myself and preparing myself for the upcoming bariatric surgery.  I just have two weeks to go and then I will be done with my pre-op classes.  Eeeeek!  At times it seemed so slow and other times it felt like it whipped by.  

Since I will be in staycation mode, I have decided to make this summer one where I rediscover my beautiful San Diego.  I have lived in the county since 1974 and I often times forget why it is such a destination for many people going on vacation.  Yesterday I decided to make a list of some places I could potentially visit this summer.  I came up with almost thirty places that are free or almost free.  I do want to also include our beautiful beaches to explore.  I think we have something like 22 miles of beaches, some of which I haven't been to in a million years. While I probably won't be swimming in the ocean, practically all of them have walking paths near the shoreline.  

One of the fun places I went to yesterday was our lovely San Diego Zoo.  I have a funny story around this.  When I was a little girl, maybe five or six, we had gone on one of our trips to the zoo as a family before my parents were divorced.  On that particular visit, I came across life-size statutes of gorillas.  As a little girl, the size of these things frightened me so much that I was wailing at just the mere sight of them.  When I say wailing, I mean I was representative of every child you dislike screaming in restaurants, airplanes and stores all rolled into one.  In fact, I was so scared that we had to leave the park.  Since that time, which was 1976 or 1977, I have not returned.  I don't know if it was because I was traumatized or what the reason was, but I never went back that I recall, even as an adult.  Here are some great pictures, including one where I encountered one of the gorilla statues again.

 

 

We had a great time and I laughed when I saw those statues again.  While they were the actual size, they were only busts on top of pillars.  Martha, you were absolutely right ... there are a lot of hills there.  When I got out of bed this morning, I felt it in my thighs.  They felt like they were on fire!  I ended up buying a year membership yesterday since it lets me get in free to both the zoo and the Wild Animal Park.  It's a great place to go walking and I can take a friend with me each time without having to pay extra.  While it's my goal to get in lots of exercise this summer, I think it's a great way to do it while also enjoying the sites.  

Pre-op class #21, weekly weigh-in and biopsies

I knew I had gained weight over the last two weeks and my class tonight confirmed it ... eight pounds.  Egads.  Yuck.  It's funny, I walked into my Kaiser class in a good mood.  Some of my friends even commented how good I looked.  I got on the scale and everything seemed to change.  My shoulders sort of slumped down and I seemed to drag myself back to my seat.  It wasn't a surprise to me though.  I wish I could say I had been doing all the right things but I wasn't.  I  hadn't been tracking my food every day like I was before and I certainly wasn't getting in all my exercise.  I'm not here to make excuses though.  It is what it is and the best I can do is to just be honest and move forward.

Tonight's class was about body image.  One of the exercises we did was to go around the room and say one thing we liked about our bodies.  Then, when we did that, our facilitator made us come up with one other thing.  Two whole things we like?  Hmm, why not just pull teeth out of my mouth without novacane?  That's what it felt like to me.  My two items were (1) my smile and (2) the strength I have to handle the chronic pain in my leg without crying in the corner day after day.  Body image is certainly something I need to work on.  As our facilitator pointed out, we need to work on loving and appreciating our bodies now, just as they are, and not waiting until some magical day when we have the surgery.  I get that.  We have to love ourselves before we can ever begin to take really good care of ourselves.  I remember when I had lost almost 200 pounds on Optifast.  Believe this or not, it was incredibly difficult for me to see any difference in my body from the 420-pound body I started out at.  I would go into stores and pick up the biggest size they had, like I used to do, not realizing that I could fit into 16's.  That's a distorted body image.  Some suggestions for things I can do to improve my body image, as described in our workbook, include:

• Concentrate on things I do well.
• Do physical things for fun.
• Voice my opinions against poor body image messages others give me.
• Be a role model of positive image.
• Get rid of clothes that don't fit.
• Don't buy clothing that I hope will fit me someday.
• Remember that I am personality AND a body.
• Remind myself of my positive qualities, not my size.
• Be less critical of my weight.
• Look at my body non-judgmentally.

Speaking of body image, boy do I have a story to tell about the visit to my dermatologist's office!  In yesterday's post I wrote about my check-up appointment with the doctor today.  I go about every 4-6 months now for a full-body check to make sure there are no questionable moles, discoloration or otherwise suspicious spots.  Up to this point, I have had five biopsies on my body after melanoma was first discovered.  I'm at the point that if something looks suspicious, the doc doesn't have to do anything to convince me to have it removed for a biopsy.  I would rather err on the side of caution then have that deadly cancer in my body again.  

So, anyway, I get to the appointment and I'm checking my cell phone while waiting my turn.  Usually a nurse will call from a door across the room but today someone came right up to me and asked my name.  "Miss B.?"  I looked up into the eyes of a clean cut, athletic, blue-eyed man who was smiling down at me and I wondered how he knew to come right up to me with a room full of patients and why was he so incredibly attractive?  He brought me back to the room, had me sit in a chair and then proceeded to check my blood pressure.  He seemed like he was flirty with me and I immediately looked at his ring finger.  Nope, nothing there.  I don't know why I did that, just habit I guess.  It's not like I was coming to the doctor's office to look for a date! After he was done doing his thing, he gave me a gown to get into for Dr. K, my dermatologist, as he left.  Dr. K. is this slight little man, a very good doctor who I feel very comfortable with.  

There were two spots on my body that were concerning.  I'm going to tell you about them so you can appreciate what I went through.  The first was under my left arm, right near the incision point where the melanoma surgeon checked my lymph nodes to ensure the cancer hadn't spread.  There was a mole there Dr. K didn't like the look of during my last visit, so he looked at it again and wanted to biopsy it.  Then, he went on inspecting the rest of my body.  This is the time where I feel as big as a house.  He doesn't make me feel that way, it's just the way I feel.  It's about my insecurities and body image issues.  Then I told Dr. K. that there was an area in my pubic region (TMI, sorry!) that had a discolored spot and I was concerned.  I wondered aloud to him if I should have my gynecologist look at it first but he told me, no, he could take a look at it.  Because I was going to have at least one biopsy done, he needed to call in his nurse for assistance, and particularly because we were going to look at the second one in a sensitive area.

So who comes bounding into the room after Dr. K. opened the door and called out for assistance?  Nurse McHottie.  Dr. K. went on to say to me that McHottie comes from the neurology department and he has a lot of experience.  There's a certain age you reach when you decide that you aren't going to be shy any more in front of medical professionals, but dang it, why did it have to be in front of someone who should be arrested for being so good-looking?  The first thing they were going to look at was the private area.  So Dr. K. holds a hand-held mirror, Nurse McHottie helps me up on a step ladder and they are both standing in front of me as I lower my underwear down so they could take a look at the area that I identified as an issue.  Could I be any more mortified???  Dr. K. is staring at it with his dermatology tools and said, "Yup, we better biopsy this area, too."  I laid on the table while he injected a numbing agent into me and proceeded to ask me if I had any plans for the summer.  Seriously?  Seriously?  McHottie was on the side trying to keep me calm.  Then, after that was done, I had to lay on my side with my arm above my head in just a bra so that they could biopsy the other area.  A numbing agent went in there too and Dr. K. was still trying to coax out of me my summer plans.  After he was done and started typing things into the computer, McHottie was treating the wound and putting band-aids on me.  While all of this was going on, I was fully aware that we were flirting just a few minutes before.  It was innocent little flirting, nothing that made me uncomfortable.  Here I was, boobs spilling out of my bra, gown practically off my body and feeling pain.  Like I said, M-O-R-T-I-F-I-E-D.

As I sit here now, I have to chuckle to myself.  The irony was not lost on me that we were talking about body image things today.  It's in these moments that I realize I just have to get over myself.  Yes, I'm self-conscious but there's no need to be.  McHottie was not the first person to flirt with me recently, I've actually had a handful of others.  I always say there's something in the water in a joking way, rationalizing that the reason men are hitting on me is because it's a full moon.  It's such a self-deprecating thing to do.  At least I could see the humor in the situation.  In terms of the biopsies, if I hear from the doctor on the phone, it means something came back malignant (not good) but if I receive them in the mail, then it means they are benign (fine).  Here's hoping the phone doesn't ring!

Those too-close-for-comfort booths

Yesterday I spoke with my mom and she told me she was robbed a couple of days ago at her dentist's office of $855.  This morning I took her out to breakfast so that we could talk.  We went to a place I have never been before and, when we walked into the restaurant, I wanted to leave.  They only had booths there and they were small.  I was afraid I wouldn't fit, but I didn't want the visit to be about me.  I barely fit into the booth.  Actually, I really didn't fit. It was cutting off my circulation, but I just kept silent and was there to support my mother.

Thankfully my mom is okay.  She has been heartsick since this happened and so was I.  My mother could have been hurt and, for a purely selfish reason, $500 of that money was for me.  She was trying to pay me back some money she borrowed about a year ago.  In the end, though, it is just money and obviously human life is so much more important.  She hadn't reported the incident to the police, so I convinced her to do so.  Even if the worst happens and she can't get the money back, maybe it will prevent it from happening to someone else.

After we said our goodbyes, I had planned to go to the beach for a walk but I turned around and drove back home.  I was feeling as big as a house after sitting in that booth and I just felt so insecure to then head down to the beach.  I know no one really cares.  The place where I walk has a path near the water designed for walkers, runners and bikers.  It is meant for people with clothes on trying to get exercise in right along the water versus those laying out on the beach in their bathing suits. In that moment though, having squeezed in that booth, I just wanted to go home.  Perhaps it was to hide away.  I just don't know.  I was able to exercise later in the day, so I pushed through and sort of got over myself.  It felt good to sweat and walk away the tension I was feeling.  It's important for me to do that and not to eat over all of that.

Tomorrow I have a doctor's appointment with my dermatologist.  It's a melanoma check-up appointment.  I'm a bit concerned because I think he's going to perform two biopsies on me.  There's a mole under my arm near where the surgeon did an incision to check on the spread of the cancer.  The last time I saw the dermatologist, he was concerned about it and warned that he may want to do a biopsy.  Then I found another spot in a very private area that is causing me a little bit of stress.  It looks suspicious.   By this time, I know what to look for in terms of new spots on my body or changes on spots already existing.  I know that, in the past, I would try to run away from the fear toward food and make some excuse not to go in and see the doctor especially since it's in a private area.

Burying my head in the sand is not going to erase the facts of the situation.  Besides, I get to take this one step at a time.  I'm going to tell the doctor what's concerning me, he will take a look at the two areas and then only perform biopsies if he feels it is necessary.  This does not mean I have cancer, just concerns at this point.  I tell you, the black and white thinking is so hard to get away from but it's what I must do. I know there are shades of grey in this world and that I don't need to jump to the worse case conclusion.  Geez, why do I do that anyway?  Of course I'll report what the doctor decided to do so stay tuned.

Started out with the end of the water challenge, but had cancer on my mind

This post was going to start out with how excited I am to have finished my 100-day water challenge.  Here's the post I put on my Facebook page this morning.

Back in January, I got involved in a "Drink Your Water Challenge" thanks to xxx. It was 5 days of drinking half your body weight in ounces of water every day. It was so good for me that I turned it into a 100-day water challenge, which I have now completed. Over these last several months, I have turned a hatred of drinking water into a habit. I'm not perfect every day, but it has been such a major turnaround. In this time, I have hardly had any diet soda, started exercising every day and dropped nearly 30 pounds as of today. Does it all have to do with the water challenge? All I know for sure is that it got me on my way. If you took up the challenge, too, I'd love to hear how you're doing. Now that I'm done, I'll still continue drinking my water because I've now come to love it.

I am so glad to have made this very important change in my life.  It's really helping me now as I lose weight and even more so when the time comes for my weight loss surgery.  Now something else has come up for me that I need to write about.

As I have shared on here before, I had cancer a couple of years ago.  This month marks two years, maybe three, since I was diagnosed with melanoma.  The difficult part with that type of cancer is that many people don't take it as seriously because it's "just" skin cancer.  The first thing most people would ask me when they found I had it was how much time I spent out in the sun when I was a kid.  The problem with that is that melanoma is the deadliest type of skin cancer and happens even when people don't spend a crazy amount of time in the sun.  Of course I felt judged, wondering if I caused this myself.  Melanoma continues to grow and, if not removed in time, it will kill you.  My surgeon was the first one to really help me understand how serious it was.  What appeared like a good-sized mole on the outside was actually embedded far into my body and required a very long and deep incision to remove it. No amount of food I could binge on would ever take that fact away.

Up to that point, I had never had a surgery where I was put under anesthesia, let alone been cut open out of necessity.  The reason I'm bringing this up now was that I was watching a movie called 50/50 tonight.  I think it came out about a year ago with Joseph Gordan-Levitt and Seth Rogan.  It's the story of two friends, the cancer diagnosis of one and walking through the journey towards health together.  It was the first time I had watched a movie about cancer since I had it.  Oh my gosh, it was such an emotional thing to watch.  They did a great job with the movie, but watching it helped me realize all that not only I went through, but also my family and friends.  My mother cried in the waiting room while I was being operated on.  My dad came in from Utah to take care of me while we waited to hear back from the surgeon to find out if it had spread or not.  I had 30 staples in my back and I was in great pain (at the bottom of this post is what my back looks like from the surgery, but I'm warning you before you scroll down just in case scars flip you out).  I had so many friends praying for my healing.

In the middle of all of this was me.

I had moments of sinking to my knees in tears.  I remember taking a shower one day before I had the operation and I just went to the corner in the shower and cried while the water continued to spray on me.  For the most part, I was numb and was going through the motions.  I did what I needed to get done.  It wasn't until I watched this movie and remembered my same moments that paralleled the character that I understood what a blessing it is that I'm still here.  Really, in retrospect, the overeating with food is just stupid.  I didn't have a situation that brought this on necessarily.  It's just that I do have those moments where I see a particular food and I want to eat it.  And for what?  Pardon my language, but I had fucking cancer.  Cancer.  The very idea of going to food to solve some problem is just asinine in comparison.  I'm not minimizing the fight we all have with it, not at all.  It's just the fears I have over not being successful with the surgery because I'm afraid that I'll still overeat is nowhere in the same ballpark as the fear of dying I had with cancer.  I don't have to fear not being successful because I'm doing everything I'm supposed to be doing.  In those moments of doubts, I can embrace whatever feelings are behind that and know that I can still keep moving forward.  I have such an amazing support system of family and friends, as well as all of you reading this.  I have a great therapist that helps me get to the heart of the fears and, especially, God who is always by my side holding my hand.

Wow, this was a pretty deep post.  I'm so grateful to be cancer-free as I write this.  Below is the picture of my back.  The long scar goes from the bottom of my shoulder blade all the way down to my waist.  The little circle above it was when we did another biopsy because there was a suspicion that it had spread.  I've actually had four such biopsies after having the original surgery.  Not serious my ass!  Okay, enough of my potty mouth for tonight :-)

Surprising result

From the lab work that was done on Monday, I thought I was done with all the tests they were going to do with my blood.  Wrong!  I happened to log onto Kaiser's patient website to look at when my next appointments were and found this message that was sent to me before a received an e-mail notification:

"All of your lab results look good, except for your vitamin D.  Your vitamin D level is low (24):  Normal range is 30-100.  A prescription is entered into the computer for you to pick up at any Kaiser pharmacy for vitamin D 50,000 units by mouth to take three times a week (or every other day) for 6 doses.

"You should also be taking over-the-counter vitamin D3, 2000 units daily as a routine supplement.  Continue taking the over-the-counter dose after completing prescription.  You will need to check lab again (vitamin D, PTH, calcium) after treatment.  Orders have been entered for non-fasting lab to be done the week of March 10th.

"You may also find the following website contains helpful information and you may purchase supplements designed for bariatric patients: www.bariatricadvantage.com."

So after reading all of that, the thing that struck me first was the part where she mentioned purchasing supplements for bariatric patients.  I wondered to myself, "Am I a bariatric patient now? Have I been okayed to move forward?"  These are legitimate questions, but probably most people would focus on the deficiency part first and worry about the bariatric label later.  Not me ... impatience rearing it's ugly head.

Back to the vitamin deficiency, I wondered how I could possibly be lacking in vitamin D.  Usually that's for people who don't get enough sunlight.  I do try not to bake in the sun since having melanoma, but I also don't hibernate indoors either.  I know it's winter time, but I live in southern California - there's generally always sunshine of some sort.  I went online to Web MD to see if I could find out what was going on.  What I saw made sense: of the various symptoms, I qualify in two areas - have darker skin and lactose intolerant.

I went to the pharmacy and picked up the prescription.  Pills with 50,000 units of vitamin D seems like a lot, but I'm sure that's just to get my levels back to where they should be.  I always think to myself that I have too many pills to take, but that is incredibly laughable because, after I have the gastric bypass, I will be taking vitamins for the rest of my life.  I am sure I will get rid of most, if not all, of my other pills as my health improves in the future.  I need to do what I need to do to get my level back to normal, so no big deal in the big scheme of things.

Some great news

After a pretty crazy day yesterday, all of my results from the tests I took posted in my Kaiser online account.  Thankfully, I appear "normal" (relative, I know!).  I received a call from the Positive Choice clinic and an appointment has been scheduled for me to meet with the program's doctor.  There he will be doing an evaluation of all of my medical records and background to determine, with me, which will be the best surgery option given my history.  I really have gotten a great insight into how much it means to me to have the gastric bypass  when I thought I might not make it through the questionnaire phase.  I have to stop this black and white thinking because I was convinced one wrong answer and I would be out on my bootie.  So I see the doctor next Tuesday and I think I'll have more definitive answers at that point as to what the next six or so months will look like for me.  If only I would hear back from the dermatology department on my biopsy!  I am feeling much better about it today.  Perhaps it was the pain of the area the doctor cut out of my back, perhaps it was because it was very close to the melanoma site ... whatever the reason to cause me a bit of anxiety, I'm feeling much more relaxed today.  For the rest of the night, I will be relaxing next to my beautiful Christmas tree. I always am reminded of past Christmases, making ornaments, wrapping presents and feeling the wonder of Santa that childhood brings.  I really have always loved the season and I think I'm finally getting in the spirit.

A cut for me is a good thing and moving on to the next step

I had an appointment to see my dermatologist yesterday.  I got a call from his office over the Thanksgiving holiday to tell me I was on a waiting list to see him for a routine 6-month melanoma follow-up appointment in February.  I told his nurse that would be fine but to please let him know I have been experiencing pain around my incision site.  I didn't realize that little comment would spark an immediate phone call by the doctor himself (which never happens with my HMO unless it's to tell you bad news) followed by a next-available visit with him.  What's basically been happening is that I have been having significant pain and tingling at the tip of my back scar from the cancer surgery and it had been happening all of a sudden so I was concerned.  He ended up looking at it and prescribing some steroids for me to help with the pain.  While I was there, we did my regular appointment so that  wouldn't need to wait until February.  That entails a full body scan.  It's a less than thrilling appointment because the doctor looks at you from head to toe, literally.  He found two moles that are "concerning" to him in addition to taking a biopsy from my back where a spot had grown in size and changed shape.  So now I have a portion of my back cut out a few inches above the surgery site and it huuuuurts. The way they do it when you get a skin biopsy is they give you a shot of a local numbing agent and then essentially take a blade and shave off the area.  The size he cut off my back is about the size of a thumbnail.  When the shot wears off, you're left with a lot of pain.  So that's been sent off to be evaluated.  Meanwhile, the two moles he found made him very silent when he was looking at them and told me to diligently watch them.  That didn't sound good.  However, I'm trying to stay as positive as possible and be guided by my faith.  I've had two other biopsies that ended up perfectly fine so I'm assuming this one will as well.  As for the other two moles he saw today, I don't want to think about worst case scenarios because, right now, they are just little moles.  With my skin type, I have dark freckles that make it hard to distinguish sometimes between that and a mole.  I do have to say that, with all of my experience in dealing with a dermatologist, I have a great respect for the profession.  When I was younger, I had the misinformed perception that all a dermatologist really did was give botox injections and maybe help with acne.  I couldn't be more wrong!  It was a dermatologist that saved my life - if he had not treated my melanoma as seriously as he did, I wouldn't be here today.  I'm so grateful for my wonderful doctor and his empathy with me.

In other news, I received a message from the Options program that I am moving forward towards the next step of the weight loss surgery process.  I have to go get lab work done now.  That includes give lots of vials of blood samples (someone told me it's over 20 vials but I have a hard time believing that's true), a urine sample, EKG and providing a stool sample.  That last part makes me less than thrilled but, whatever, I gotta do what I gotta do.  I'm really happy I can keep moving forward.  For some reason, I had myself convinced that they would reject me from my answers in the questionnaire.  I know it's silly, especially given I have co-morbidities that make me the perfect candidate for the gastric bypass, but I have to be honest that it was a concern of mine.  I have discovered how very much I want to pursue this surgery that any disappointment along the way, perceived or actual, affects me greatly.  I found a really great group on Facebook that is a great source of support.  If you're interested, search for "Gastric ByPass Surgery Stories".  There are about 5,000 people in the group and the only people that can see your posts are other members, not everyone on your Facebook friends list.  It's a really active group with great before/after pictures, advice and people sharing their experiences.  I have come to really understand how absolutely necessary positive support is for long-term success with the surgery.

Cutie patootie and the phone calls

I went to my physical therapy appointment today to deal with the leg pain.  I got to meet Mr. In-Top-Shape Physical Therapist and his dazzling white smile.  He actually was very nice but a bit too good looking for an early morning appointment where I knew his hands would be on me.  It's in those moments that I am uber-aware of my body and how much I would have loved to lose 100 pounds in five minutes by clicking my heels together three times.  It's hard not to compare the unflattering parts of my body with a lean, sculpted body.  I'm trying not to compare, especially man versus woman, but I went there anyway.  Outside of all that, however, he actually was able to get to the heart of my pain.  When he was doing the exam on me, he had to touch my legs and put pressure against my muscles to see where I hurt and man alive was it painful.  He gave me some exercises to work on until our next session.  He did scold me for pushing my body too far when I'm out walking.  He said, at least to start, I really need to curb the amount of time I spend walking.  For example, I should not be walking for anywhere near an hour or more, not right now at least.  I need to build up to that to see where the pain is coming from and then we can reassess.  Otherwise, he is telling me that I need to do non weight-bearing exercises like the station bike, elliptical, swimming, etc.  It's just another reason to move forward on the surgery; relieving me of pain is a big deal.  I go back to see him on November 25th, so I'll be working on the exercises he gave me in the interim.

During yesterday's post, I talked about going to get my mammogram done.  The sweet woman who performed the procedure told me I would find out the results by mail unless something came out abnormally.  If that was the case, I would get a phone call.  So, while I was working today, I missed a call from my doctor's office.  It turned out it was just a reminder to get an eye exam since I have diabetes.  Okay fine.  Then, later on, they called again.  So when I listened to the voicemail message, it was a reminder of an upcoming appointment.  Of course, I don't know any of this when I see "Kaiser" in big letters on my phone.  All I know is that my heart skipped a beat each time.  I have had cancer before, albeit not breast cancer.  I have, however, received the call I was not supposed to receive to tell me the test results showed me positive for cancer.  Your world crushes in around you in that moment.  Feeling relieved from the second call, I was trying to convince myself that nothing was wrong with my mammogram results and to just calm down.

Then the phone rang for a third time.

Seriously??  Yes, it was "Kaiser" calling me again.  This time I was able to pick up the call.  My heart was beating a mile a minute.  The woman on the phone said:

"Is this Kathryn?"

"Yes it is." [I'm attempting to not freak out.]

"This is XXX from your doctor's office."

"Hi!  How are you?"  [Trying to fake that I have no fear inside.]

"I was just calling to ... remind you about your colonoscopy procedure on the 19th."

Are you kidding me right now?  I swear I stopped breathing.  Here I am just going in for a routine exam to make sure everything is in order, just a preventative measure, and I had a moment there where I actually started to worry.  I think it was another great reminder for me to just try to stay as calm and patient as I can unless I have reason to react in another way.  I suppose the fear was just remembering that moment in time when I learned about the melanoma coursing through my body.  I never want a repeat of that moment when I doctor tells me over the phone that I have cancer.  I can't describe what it does to a person but I'm sure you can imagine.  I don't want to relieve that difficult time all over again.  So far so good on no more phone calls coming from Kaiser.

What, then, is my journey?

In church on Saturday, I heard one of the most powerful sermons from my pastor.  He spoke it with such passion and it was one of those times where it felt like it was just for me.  It was all centered around the knowledge that God is at work in you right now, in this very moment.  When we don't think we're able, when I don't think I'm able, I am reminded that above all things, God is able.  It really touched me because it helps me remember that it is my guiding principle.  As I walk through the battle of getting healthier and losing the weight, sometimes it feels incredibly daunting to know the road I have in front of me is a very loooong one with a lot of weight on it as well as a lot of physical pain coursing through my body.

Then I got a huge reminder of where I've been tonight.  One of my friends posted a link to this news video of a man who was recovering from a double lung transplant and then was diagnosed with terminal cancer.  One of his wishes was to walk two of his daughters who are unmarried down the aisle before he died.  So they all got dressed up and that's precisely what he did and then he passed away.  The type of cancer he had was melanoma, the very same  cancer I had two years ago.  It's the very same cancer that is evidenced on my back and under one of my arms with two big scars from surgery to remove it.  It was a very sobering realization.

Sometimes the battle with food, being healthier and just the whole weight loss thing in general doesn't feel like such a big deal in the grand scheme of things, especially when people are dying of cancer.  Yet, it's also something I can't minimize because this is so much bigger than eating a little extra food.  It's a symbol of something greater going on inside of the person that has the issues with that food, like me.  At the same time, I see how powerful God is.  I had melanoma and it certainly is fatal if not removed from the body.  I was fortunate that it had not spread more than it had already spread so they were about to surgically remove it.  So I wonder ... why am I still here?  I'm not saying that in a morbid way, not at all.  It's just that I can reflect on this man's story and on my own and I can know, without a shadow of doubt, that God has an amazing plan for me.  That's why I'm still here.  Yet, what is that plan?  Care to clue me in on it, God?  Pretty please??

Maybe His plan is this very thing that I'm doing right now ... posting my journey and my story on this blog as a means to show other people how He works through me.  Who knows why in the world I got it in my head one day to start this blog.  I'm not like other bloggers - I don't have even an iota of interest in making money on my blog.  I know there are others out there that advertise but you'll never see that on my site.  There's nothing wrong with it, but for me, my blog is purely about the journey.  If other people see it, that's fantastic.  If other people can glean something helpful from it, I'm thrilled.  At the end of the day, though, it's the story of me and the road I have traveled.  Father God, where is this road going to take me?  I just don't know, but one thing I do know for sure - I don't feel alone while traveling on it, not right now.  That's a huge blessing and a gift I cherish so much.  All of the people (yes, you!!) who read my musings support me more than I could ever express.  I don't know what this journey is all about, but hopefully I'll come to understand it all soon.

Don't mean to complain, but ... seriously??

You know that saying, "When it rains, it pours?"  Well, I learned this week that that is the biggest friggin understatement ever.

As a follow up to my whole anemia vs. what's really wrong with me saga, I was able to get an appointment with a neurologist for Monday.  I already had meetings scheduled at work, but lovely friends/co-workers stepped in to cover for me so that I could keep the appointment (I just work with the best people ever.  Hands down.)  At the appointment, I am hoping there will be some answers.  I also need to face the very real possibility that it may be time to transition from a modified program on Optifast to getting back on food to lose the rest of the weight before going on maintenance.  That's only if they can't find out what's going on, but it's something I have to give serious consideration.  I'm not ready for that, at least not in my heart.  Yet, I wasn't ready to go on the modified fast either.  Ultimately, my health is the most important component of this and with incredible lightheadedness and weakness in my legs every single day, it's something that may be the common denominator in all of this.  Everybody reacts differently to taking products into their body and mine may just have had enough of it after eight months.  However, I'll cross that bridge when I come to it.

Later that afternoon, I have to see my worker's comp doctor so he can look at the progress in my arms.  I'm still in major pain there and it hasn't gotten better since I saw him last month.

Then, later that evening, I have my Optifast class where I'll be stopping by the medical office before the meeting starts and review the findings of my appointment with the neurologist.  It may be at that time that I make some difficult decisions on whether to stay on the modified fast or do something different with the Optifast products.

Meanwhile, in about the last week or so, I have had horrible spots appear on my body that are very itchy.  I mean itchy!  Have you ever had a cast before and found yourself desperate to scratch the inside that you grabbed a wire hanger to stick down in there and go to town?  No?  Just me??  Well, memories of the summer I broke my arm during sixth grade came flooding back as I have been dealing with these spots that are overwhelmingly begging me to scratch them with every fiber of my being.  Come on Kathy, you know you want to scratch right there.  Right.  There.  Here's what my legs look like, just to give you a visual reference.

The pics don't even do justice.  My ankles are swollen and these spots are all over my legs with some now on my tummy, arms and back.  These are the prettier spots ... some are very splotchy and just kind of yucky to post on the blog.  They itch like mad so I decided to go in and see a doctor today to get some sort of relief.  [As a side note, when they were taking my vitals, the nurse was able to use a regular-sized blood pressure cuff on my upper arm for the first time in my life - up to now they've always had to use the thigh cuff to measure my blood pressure there.  That was a huge victory.]  The doc took pictures for dermatology but told me that essentially she thinks it's a bad rash since she was able to rule out other causes.  We couldn't pinpoint what it could be ... I have cats but they're indoor cats and don't have fleas, I haven't done any activity out of the ordinary lately, haven't eaten anything weird, nothing like that.  The doc told me that I wouldn't hear from her unless dermatology had concerns and wanted to see me and to just take some prescription-level ointment and Claritin.  The last time I had pics taken for dermatology was when the odd-shaped mole on my back led to a concern from the dermatology department and, after performing a biopsy, it turned out to be a form of deadly cancer, melanoma.  So, I was hoping I didn't hear a peep back from dermatology today.

I heard back from them.  

They want to see me after getting the pics and written report from the doc.  So I get to do that on Tuesday.  Meanwhile, the cream is not alleviating that feeling of wanting to scratch my skin, so I'm going mad over here right now.  Also on Tuesday, I meet with my physical medicine doctor to see how the progress is going on the back pain I'm trying to deal with.

Speaking of that, I had the second appointment with my acupuncturist today.  I practically cried during the portion of our visit where we talk first before she works on my body. We talked about body image and why in the hell I am hanging onto clothes that no longer fit me.  They are in boxes, ready to be donated to charity, but I haven't made the call yet.  In those boxes are a shitload of clothes that are from 1-9 sizes too big (I can't explain why I'm cussing so much tonight, but sometimes polite words just don't do it!).  I was wearing pants to our session today that are four sizes too big, held up by a belt that is also way too big on me.  I told her everything that is going on and the stress I'm feeling.  It just feels like my poor body is falling apart.  I know it's not and that it needs time to adjust to the drastic and sudden changes, but it feels a bit overwhelming.  Couple all of that with a stressful job that I happen to love, trying to go to school at night, not getting more than 3-4 hours of sleep at night, being in pain every moment of the day and just being pulled in so many different directions ... well it's no wonder that I just need to chill out as much as possible!!  I totally fell asleep on the table during acupuncture with numerous needles sticking out of me.  You can't even begin to imagine how soothing it is.  No, seriously, it's an incredibly calming feeling, especially with soft music playing in the background and the lights turned down low. 

Even with all the worries, fear and stress I'm feeling right now, I need to stay in the positives:

• I get to get some extra sleep this weekend
• I get to spend some time getting some extended physical activity in that I desperately crave
• I get to spend some girl time with a friend on Saturday that I haven't seen in a few weeks
• My health is so much improved ... no more high cholesterol, high blood pressure or high blood sugar.  In fact, those things are normal now.  The nurse practitioner at the Kaiser clinic referred to me as a "patient who used to have diabetes" when she was describing my situation to a colleague.  What do you mean used to have?

At the end of the day, my worst day in a thinner, healthier body is so much better than my best day in a 417-pound body.   This is a time of challenge for me, but I am rising to that challenge and feeling so much stronger as a result.