Biopsy results and following the rules

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

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

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

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

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

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

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

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!

Taking this time for myself

Approaching the start of this summer, I knew I wasn't going to pursue much work while I was on vacation from my job at the high school.  I thought about it since I don't earn a salary during the summer break, but I also knew that I would need to give myself time to go to all of the medical appointments leading up to the surgery.

The pre-op classes ended last week and so I'm focused on things coming up.  Within the next several weeks, I have about ten various appointments and that doesn't even include meeting with the Pacific Bariatric psychiatrist, internist and surgeon.  I'm continuing to see my therapist, meeting with the sleep specialist, I've got the fit test on Thursday and so much more.

Like a lot of people I know, I have a tendency to take care of other people before myself.  Well, now is finally the time - just like the name of my blog suggests.  Now is the time to put my health first.  Now is the time that I focus on what my needs are as I walk forward into major surgery.

I've spent some time this summer (so far) with friends, but I've also spent some time alone, too.  It's okay to be alone.  I always associated being alone with being in a depressive state, at least for me.  In the past, I chose to be alone because I was isolating.  Now I am choosing some time by myself because I am embarking on a huge change in my life, one that will impact me for the rest of my life.

Having the surgery is not a decision I take lightly at all.  I don't joke about it and I have given it serious consideration at every turn.  Part of my alone time has been focused on talking and praying to God, getting back into His Word.  I am strengthening my faith as I move forward and I know I will continue to do so as I move closer to the day when the operation will take place.

In the meantime, I am also appreciating time with friends and family, remembering what an amazing support system I have in them.  I know I have incredible support online as well.  I have met some pretty terrific people through this blog, Twitter, MyFitnessPal and Instagram.  Sharing my story with other people reminds me that while this world is big, other people travel the same roads I do and if they can do it, so can I.  I'm taking these days one at a time and putting one foot in front of the other.  I'm remembering to stop and breathe through the fear and excitement I feel.  Breathe, Kathy, breathe.

Finished my pre-op classes and weekly-weigh in

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

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

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

It really was a miracle

Somehow, in the middle of my frustration and tears about not being able to sleep, came a grace from God that is unexplainable to me.  Miracles happen every day, some large and others small.  My small miracle (although I consider it to be huge) is that I was able to finally fall asleep on the CPAP.  I really don't know how it happened, other than my complete surrender and humility to ask God for the help I was desperate to receive.  When I went to bed last night, I prayed a lot and, I admit, cried a lot.  Frustration and sheer exhaustion will do that to a person. FYI, it's hard to gracefully cry with a nasal pillow on your face ;-) Sleep didn't occur right away.  In fact, it took several hours to happen, but eventually I did fall asleep with the machine.  The gratitude I felt this morning when I woke up practically brought me down to my knees.  It is a miracle ... I have been trying for months and months to sleep with the mask.  Only after a deep surrender did it happen.

After I woke up this morning and had my breakfast, I decided to go for a walk by myself at the beach.  Of course, being "by myself" on a Southern California beach in the summer is impossible, but no one was able to go with me and so I went alone.  I was able to tune out the other people around me and just focus on what I was there to do.  Check out what I experienced.

It was a perfect day.  I felt a lot of peace and that was reflected in my food choices.  I've been having protein drinks to replace some of my meals since I'm getting closer to surgery, but I have not felt deprived nor am I going in the kitchen looking for food to eat.  There's just a lot of simplicity there without feeling deprived.

Tomorrow is the last day of my six months of pre-op classes.  While I'm glad to be done with this part of the process, it is a bittersweet step at the same time.  I've become good friends with my classmates and I'll miss seeing them every week, as well as our leader.  We have decided to continue meeting, though, to support each other as we go through this process.  We probably won't meet every week like we do now, but I'm sure it'll be 1-2 times each month.  In the next several weeks, a lot will be happening in terms of getting closer to a surgery date.  It's not something I need to fear, though.  God is with me every step of the way in my life as long as I invite Him in.

Pre-op class #15 and weekly weigh-in

It's funny how different perspective can be, isn't it?  I went to my pre-op class tonight and lost two and a half pounds at the weigh-in.  I was happy about that number, but a little disappointed as well.  I thought to myself, "Hm, only two and a half pounds after how much I killed it this week?"  I thought about everything I did wrong, at least in my head, during the course of these last seven days.  I have been trying to avoid eating bread, rice and some other carb-laden foods, as well as sweets.  For the most part I have done well, but I did have a few things throughout the week that had more carbs than I would have liked.  Yet, when I posted my weight update in MyFitnessPal, I received quite a bit of congrats from friends.  Funny how I was doing the blame-game while they were celebrating the loss.  I have so much to learn from other people.  This weigh-in makes it a loss of 75 pounds from my highest weight and 26 pounds since I started the pre-op Kaiser program.  That is definitely something to celebrate.

Our class tonight was about the post-op diet we will be dealing with after the surgery.  It was a pretty intense conversation.  Many of the things we talked about were things I already knew because of all of the research I've done on my own.  They were things like:

• My stomach will only be able to hold just a few tablespoons of food after the surgery.
• No mixing protein shakes in a blender unless I wait for the bubbles to disappear otherwise it'll create air pockets and gas in my system.
• No drinking a half an hour before, during or after a meal because my tummy will need the space for protein.

The list is much longer, but these were just a few things that I got reminded of during our discussion.  I've read these things before but I guess discussing them as a group and getting a glimpse of reality after the surgery was pretty much in my face.  I shared with others in my group that it feels like a mourning of sorts.  That's hard to explain to others that are not going through this same process, but it's the death of a life that has become familiar, even if it wasn't healthy.  My go-to response for a lot of things in life is to seek comfort or familiarity with food.  Feeling bored?  Go in the kitchen and eat something.  Feeling stressed?  Food makes it better.  Feeling anxious?  Food calms you down.  For me, it will be a whole new way of reacting to life and being present in it.  I'm certainly not complaining because the flip side of that is that I will have far less pain, I will have less ailments and I'll feel overall much healthier.  

When I think about the seriousness of this surgery, it can be a bit overwhelming.  This is, after all, major surgery.  When I had cancer, I had major surgery as well.  There is a scar on my back from the bottom of  my shoulder blade almost down to my waist on the left side of my back.  There is also a scar under my left arm.  The long incision allowed the surgeon to go deep into my body and remove the cancer cells.  The area under my arm was to make sure it didn't spread to other parts of my body.  I had 30 staples in my back.  There was a lot of healing that had to take place.  In the same respect, the vertical sleeve surgery is incredibly serious.  The surgeon will be taking out most of my stomach.  For the rest of my life, I will have to eat and drink differently.  I will have to take care of my body in a way that I never have before.  It's so much more than just watching what I'm eating.  I will still have to do the work.  If I think I'm working hard now with watching what I'm eating and exercising routinely, that will probably be increased tenfold.  I have a healthy respect for this process and I'm seriously not trying to overthink it, but it felt a bit overwhelming in class tonight.  I'm so glad I have a place where I can just write about what I'm going through.  It helps me process everything and be reminded that if God brings me to it, He'll also bring me through it.

Water Challenge Day 93:  Drank 178 of 178 ounces 

Pre-op class #13, weekly weigh-in & lab results

This week's pre-op class about understanding the basics of gastric bypass surgery as well as some great questions to ask the surgeon when it comes time.  Right now, I am choosing to move forward with the vertical sleeve.  However, if my surgeon will only support the bypass, then I will yield to his expertise.  For diabetics, a lot of medical professionals do recommend the bypass because of how many patients come out of the surgery with their symptoms of diabetes in remission.  However, it is not guaranteed and it does happen with the sleeve as well.  Don't get me wrong, I'm not discounting the bypass at all.  I just have a preference for the sleeve due to the lack of malabsportion issues and my insides will not be rerouted.  Besides, anything with less potential complications is something I'd like to do.  The way the program through Kaiser works is that you complete the six months of pre-op classes and then begin meeting with doctors and a psychiatrist before then having the surgery.  Next month I will be going to an information session with one of the surgeons to learn more about the specific process and to receive more paperwork to complete.  It seems like things are actually happening rather than just waiting around for the next step that seems months away.

My weigh-in was good ... I lost three pounds.  I am thrilled to continue losing weight.  I have really kicked up my exercise since I got the Fitbit.  In fact, I just received an e-mail today telling me that I have passed the 50-mile mark.  So I've walked over 50 miles in the 11 days I have had it.  I know I keep going on and on about this lovely little gadget and I'm sorry if you're rolling your eyes at me (I know someone out there is!), but it has really motivated me to get moving.  When I returned to work today, I thought to myself, "I can't sit down - I have places to walk."  Being gone from the office for a week meant I had no choice but to sit and catch up on phone calls and emails but I was able to go for a walk during lunch.  Then, later in the evening, I walked in place in my living room while watching a show.

I did receive some results of blood work I had completed recently.  One of the things was that the bariatric surgery care manager wanted to have my vitamin D level looked at again.  Back in December, my level was out of the normal range so I had to take 50,000 units of vitamin D for a while and then take 2,000 units of vitamin D3 daily after that.  Now my number has moved from a 24 to a 31, with the normal range being 30-100.  While they are glad I'm now normal, the case manager states that it is much more effective if it's in the 50-60 range so now I need to take 3,000 units of vitamin D3 daily.  Of course I will do what they want.  I'm not going to sit in regret about what I "could" or "should" have done.  I'm just going to keep moving forward because that's all I can do with that, or most anything else for that matter.

Water Challenge Day 81:  Drank 187 of 187 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

Pre-op class #6 and weekly weigh-in

I connected with my primary care doctor today to discuss the low blood sugar reading I had yesterday.  In fact, looking over the last two weeks of numbers, yesterday was not the only time I was way too low ... it was the fourth.  She is making an adjustment on my medication, so hopefully things will improve.  I'm glad I consulted with her because I actually had another low reading today when I came home after my pre-op class.  I hate even typing that to be honest because I know people are concerned.  Trust me, so am I.  This keeps me accountable.  Somehow posting what's going on for whoever happens to read my blog keeps me really honest.

Speaking of the class, I lost another two pounds for the week.  Yay me!  It's been a slow but steady decline, so I'm happy with that.  When I look at the alternatives of either gaining weight or staying the same, I'll take it any day of the week.  Tonight our topic was about assertiveness.  I can really see how assertiveness, or lack of it, can cause me to go to food instead of dealing with something.  When I think of situations, I completely see how that works.  I have a simple but good example of this.  When I have to order more contact lenses, I do it at Costco.  When I did that last month, there was only one person working at the counter with a long line of people patiently waiting.  A person came up and actually cut in line, even though a bunch of us had been waiting for a while.  Instead of saying something, I let it go.  Something about not wanting to cause a fuss because I think I would have been rude if I would have said anything.  Of course, no one else said anything either.  Then later on, when I got home from shopping, I found myself munching on food even though I wasn't particularly hungry.  At the time, I knew it was because of Mr. Line Jumper and the fact that I didn't say anything.  Sometimes I have no problem being assertive, yet at other times it's a struggle.

Our facilitator discussed the fact that, in her opinion, overeating is a misguided attempt to fulfill unmet needs.  She's right.  Did I really have to pick up food to deal with the fact that I was mad at Mr. Line Jumper and even madder with myself that I didn't say anything?  What purpose was the munching going to fulfill for me?  Honestly, all it did was make me feel bad for having snacked unnecessarily, making me then want to keep on doing it.  It's such a negative cycle that feels like a vortex I can never get out of once I start picking up the food in the first place.  It reminds me of that movie "Groundhog Day" with Bill Murray.  Have you seen it before?  It's such a perfect example of this cycle.  They guy is living the same day over and over again.  No matter how hard he tries to get it to change, somehow he can't get out of the trap he's in of playing the events over and over again.  That's what a food addiction is like to me.  I say to myself that it'll be different this time.  Yet, when I go to the food for reasons other than nutrition to fuel my body, the guilt of that then convinces me to carry on until I've eaten the whole thing.

I really need to spend some time in reflection of how my overeating has been a cover to fulfill unmet needs and really identifying exactly what those unmet needs are for me.  Awareness of that will go a long way to continued good health.  At the same time, I need to keep moving my feet and my seat.  Using the MapMyWalk app on my phone every time I exercised, it showed me that I walked 10 miles last week and burned 3419 calories.  That seems pretty awesome to me.  One step at a time.

Water Challenge Day 40:  Drank 183 out of 183 ounces

Pre-op class #3 and weekly weigh-in

This week's Options class was about embracing change.  Ah, change ... one of the most difficult things for most people to deal with.  I don't know many people that really love change.  If anything, most of us just deal with it.  Of course, it can be very positive as well.  I recognize that my process leading up to the gastric bypass is a series of many different changes.  My challenge will be how willing I am to handle them head-on or if I will try to bury my head in the sand.  With change comes choice.  The fact is that I can choose to change or I can choose to stay stagnant.  That's the beauty of this entire process - all these things are up to me.  I am challenged to look within and see if I am really willing to do the work or if I just want to get away with the base minimum.  It's an interesting thing to think about.  Obviously I want things to be better and to feel healthier.  But the question is if I really do want it.  Do I want to be able to eat whatever I want, whenever I want or do I sincerely want to live a healthier life with healthier choices?  There's this pouty little girl inside of me that says, "Ick, how boring!  Enjoy that life eating rabbit food."  Yet, there's that other part of me that is tired of feeling aches and pains all the time.  She wants to breathe better, no longer have diabetes and just live a longer, more vibrant life.

There were some practical things I can do to continue countering negative beliefs and feelings into positive ones.  One of the challenges for me this coming week will be to immediately counter any negative thoughts I may have about myself with something positive.  Many people who have weight problems say a lot of negative things about themselves, myself included.  I can't even express how many times I'll pass a mirror and say something negative as I look at my reflection.  It's horrible that I do that because no one deserves it and, really, that's the whole point of the exercise.  Speaking of making change, one of the charges we have throughout the classes is to start incorporating practices now that will help us transitioning after the surgery.  One of the great tips was to try to eat slower by using baby utensils or, even better, use chopsticks.  Sounds like a great idea but I can't use chopsticks!  I never mastered that skill. I'd be sitting at the dining room table 2 hours after everyone else has left if I ate with them. The more I thought about it, though, the more I thought it was a great idea.  This will definitely slow me down if I'm hurrying and I'll learn something new.  See, I'm picking up all kinds of talents and skills along the way in this journey.

My weigh-in this week was pretty nice - I lost a couple of pounds.  I'll gladly take it!  My water intake has been pretty good overall.  I just need to figure out what's going on with using the CPAP machine and I think I'd be feeling fantastic.  Lack of sleep is extremely frustrating.  I saw one of my doctors today and she prescribed some sleep meds to use in conjunction with the machine, so hopefully that'll just knock me right out.  I pray I will fall right into bed and sleep the whole night through.  Mmm, that sounds devine!

Water Challenge Day 20:  Drank 168 or 186 ounces

Pre-Op Class #1 and weekly weigh-in

The first class is done!  There's a total of 14 of us.  Everybody seems very friendly, as does our leader.  Of course I did the thing we do with each other ... compared my body against hers and hers.  Some were smaller than me, some bigger but we definitely have a unique situation in going through something so incredible together.  I hope to get to know everyone well over our time together.

We have a 24-session curriculum to go through.  I'm glad to see it was not just about logistics of the surgery but more about the emotional reasons we eat and how to be successful in the long term.  That's something I'm most definitely interested in.  Losing weight is much easier than the maintenance part, not that losing weight is easy at all.  In comparison, though, it's like night and day.  Some of the program goals presented to us are things I want to try to incorporate routinely now.  They include:

• Having a sustainable eating plan for weight loss that is well balanced, healthy and calorie-controlled
• 30 minutes of aerobic activity (walking, swimming, biking, etc.) daily
• Two or three 30-minute sessions of weekly resistance training
• Stretching daily

I like to have my parameters set before me, especially when discussing something like surgery.  If someone tells me I need to get in at least 30 minutes of aerobic activity each day, my mind starts to go to the place of being lectured by parents, doctors and others.  "Do this because it's good for you."  Of course it is, but I don't want to be judged or shamed in the way I have been with that voice that has said, "Geez, it's only 30 minutes a day ... what's your problem?"  But when I'm told that it will prepare me well for surgery and make me successful after surgery for reasons A, B and C, then I get it.  I have six months to gradually make these things habitual so that when it comes time for the surgery, I'll feel more prepared.  Speaking of the surgery, it looks like most people have it no sooner than a month and a half after the classes have ended.  Sometimes it can be longer, but I'm glad I have a better idea.  Our last class will be on July 7th, so that will put me at surgery no earlier than the end of August. 

In terms of my weigh-in, I'm at 372.2 today, just a few ounces up from my original starting weight when I was approved for the program.  They want me to strive to lose 37 pounds during these six months.  If I don't lose the weight, it's not a deal breaker.  However, the lower my weight is at the time of surgery, the less risk I have for potential complications.  That's a great incentive to do the best I can during this time to really focus on treating my body well by taking good care of it.  My personal goal is to have adopted a healthier every day lifestyle so that, by the time I have the surgery, I won't have to start a totally new way of thinking and being ... I can just continue.  

Now what I need to do during the week is to make sure I log all of my food and any physical activity I do.  I will be required to either turn something on on paper or show a log of anything I've put int MyFitnessPal.  I've been kinda lax on logging everything in, so this will keep me accountable.

Water Challenge Day 8:  Drank 140 of 186 ounces

Why I haven't posted in a few days

I have been sick!  Terrible coughing, wheezing, sneezing, fever ... just yuck.  Even my cats meow at me when I get in a coughing spurt.  So, against what I really want to do, I have been staying put in my house to get better.  I have to go back to work on Monday after two weeks off so I'm trying to be in the best shape I can.  I know if I'm not feeling better by then, I can stay home but I complete have cabin fever.  I went out this morning to get more chicken soup because I just wanted to see the sunshine.  I could have called someone, I have a few friends that live nearby, but I wanted to feel like a human being for a few minutes.  Between that and checking my mail, I felt incredibly winded.  It's so hard when you feel bad and still have to deal with the issues of being overweight - it makes things a lot more painful.

Speaking of being overweight, I have a person I was a friend with on Facebook that constantly put in posts about "stop being fat and lazy ... get off the couch and move" or "I don't get why fat people can't just eat better and put the fork down".  In fact, she talks about nothing else.  She had gained some weight while she was pregnant, nothing more than about 30 pounds with each pregnancy and now has this holier than thou attitude because she was able to lose it.  So I finally hit the unfriend button.  I was sick and tired of her being so judgmental about something she doesn't know.

Yes, we all have weight issues, but there are some, like me, that this is so much more than calories in/calories out.  I think most people reading my blog know what I'm talking about.  There are deeper issues at play here than just choosing that food over this one, exercising these many days to burn these many calories, or having to lose 30 pounds versus 200 pounds.  What about the person that feels compelled to eat the whole bag or container?  What about a person that has a "relationship" with food because it comforts them, just like alcohol and drugs does to other sorts of addicts?  I finally said to myself, "Enough!"  I just don't need toxic people in my life.

In a few weeks, I will be starting the pre-op classes for my gastric bypass surgery.  I ordered a few books off of Amazon to learn more about other people's experiences in an in-depth way (love, love, love Amazon by the way - got one of my books for a penny).  There is a lot online about gastric bypass, but I wanted some deep info about how they cope with having surgery, how they deal with the massive amount of weight that is lost and especially about the emotional feelings that will undoubtedly surface.  Several of my friends have been urging me to turn my blog into a book one day about my experiences.  After reading these books, I can completely see how that might be possible.  It seems a lot easier than I had imagined it would be.  I'm not saying I will write the book, but never say never!

The present moment

The last couple of days have been emotionally difficult in dealing with the devastating news about my graduate program in terms of working in my district after the program is done.  However, I am in a much better space now.  While the bad news is still hard, I have had great conversations with very supportive friends and have spent a lot time in prayer about this.  I am still going to move forward with grad school with the intention of doing school counseling in the school district where I now work.  I have administrative support standing up against the current policies and, who knows, maybe something will change by the time I'm done with my program.  In the event that nothing has changed, then I will walk in faith, knowing there is place for me somewhere.  A good friend reminded me that God does not give us gifts for no reason.  Perhaps the way we intend to use those gifts will look different, but there is a plan.  The thought of leaving a district in which I have not only attended as a student myself but have worked for so long is very hard, but I never walk alone in any of this.  Maybe there is a place I am needed more than where I am now.  Who knows what the future holds.  All I know is that I need to stay in the present moment and continue walking forward in as much peace as possible.

In other news, I'm grateful that I'm now on vacation for two weeks.  It really is a welcome break, that's for sure.  I'm looking forward to spending time with friends and family as well as just getting rejuvinated.  My mom will be coming to my home and spending a few days with me since she also has some vacation.  I'm glad I can provide a comfortable place for her when she visits.  She rents a room in a mobile home where she lives now since it is about five minutes from work for her, so coming to a place with extra space is something she enjoys.  I know there will come a time, after she retires from work and gets a little bit older, where I will have her come live with me so I'm glad she finds my home so comfortable.  Our relationship has certainly grown leaps and bounds.  There has been a lot of healing there from a childhood that was riddled with abuse on her part and to a honest, loving adult relationship complete with forgiveness and love.  It has taken a lot of work for both of us to get there and I know we both continue to work on it, but our relationship is much more than I could have ever dreamed of than what we had in the past.  God really shows me how wonderful forgiveness can be.

Since my bariatric surgery pre-op classes start next month, I have been doing some more research and just reading more stories of people's experiences with having the gastric bypass. I'm reading a book now where a woman recounts her experience with all of her weight loss attempts leading up to surgery and how it positively impacted her life afterwards.  It is very inspiring and gives me a great insight into what to expect in my own journey.  Of course, every reader of this blog will get to experience my own journey.  I share my experiences not only to be encouraging to other people but to help me as I walk through the challenging days ahead.  I feel that writing is such an incredible tool to help me through emotions instead of wanting to pick up food to help me deal with stress, happiness, boredom and whatever other feelings arise.

As I think about the months ahead and the journey I now find myself on, I realize this is another circumstance in which I need to stay in the present moment.  Otherwise, it might feel incredibly overwhelming.  If you think about it, this is a major thing I am walking through. Having my stomach cut to the size of a thumb and having "rewiring" done with my intestines is beyond intense.  I'm so glad my pre-op classes will be starting in the next several weeks so that a lot of the questions I have will start to get answered.  I have no idea how people who go down to Mexico or somehow do their gastric bypass so quickly without pre-op classes possibly feel comfortable with making such a huge change.  I have gone through a lot of emotions in the process already since the day I decided to pursue the surgery and I know I'll go through more in the 6-8 months ahead.  I'm thrilled I'm not rushing through this process so that I can wrap my brain and emotions around what will be happening.  Thankfully I have such an amazing support system.  In fact, I just told the principal where I work about my surgery and he was incredibly supportive.  He could have reacted very badly because it means I will be missing at least two weeks of work right when we return from summer break.  However, his concern was me and my health.  These are the types of people I am choosing to tell about the surgery, those that will be supportive and not judge me for taking the easy way out (at least in their perception).  This is not the easy way out, trust me on that one.