Weekly weigh-in

I lost 3.4 pounds this week, bringing my total to 56.5 pounds since the surgery.  Hooray!  Even better is the fact that I'm in the 200's now.  That is very emotional for me.  I remember the day when I was regaining weight lost after Optifast and I was telling myself that was 300 pounds was my limit in terms of the highest I was willing to go again.  That was my line in the sand.  Sadly, that turned out to not be true at all.  At the beginning of this, I was wearing a size 30/32 and now I'm fitting into 22/24.  Holy smokes, that just blows my mind on so many levels.  Needless to say, I'm glad I chose to have the gastric bypass surgery.  It is a tool ... it doesn't do all the work, I do.  But it has been a beautiful gift to me.  I continue to be frustrated by my tummy that seems to be upset with a lot of different foods, but I'm finding my way.  Hope everyone is doing well!

Weekly weigh-in and feeling beautiful

Sorry I'm a few days late postings stats for the week. This week's weigh-in had me with a loss of 3.5 pounds.  It was that time of the month so I was glad to lose what I did.  In fact, I'm happy for every single pound.  It's so amazing to be going through this experience of watching my body shrink before my eyes.  You know how it is just gaining and gaining, feeling clothes tighter and tighter.  Now when I look in the mirror, I'm experiencing clothes not fitting but because I'm swimming in them.  So surreal.  I'm just a few pounds away from being out of the 300's.  Praise God on that!!

If you follow me on Instagram, you will have already seen the pictures and post below but I wanted to share it here on my blog as well.  Occasionally, people will participate in various challenges on Instagram on posting certain kinds of pictures just for fun.  One, for example, is called #stopdropselfie where, if you're tagged by someone else, you take a selfie and post it.  So one of things going around now is to post five pictures that make you feel beautiful.  So here's what I posted, both the text and pictures.

As I started seeing pics people were posting of five photos that make them feel beautiful, I started loving what I was seeing in others and their evolution into seeing their own beauty. At the same time, I was secretly hoping no one would tag me. It's not because I didn't want to participate but because I don't think I'm attractive. I hate admitting that but I vowed to myself that I would always keep it real here. I am of mixed ethnicities so I always felt like I didn't fit in anywhere. Men weren't fawning over me except for one night stands and so I had myself convinced I just must be awful, never mind the fact that I have people calling me beautiful everyday and my ex boyfriend told me that all the time. Anywho, while I was hoping not to get tagged, five amazing and beautiful women did tag me. And to them I wanted to say thank you - @joye_in_the_journey@mindfullyweighting @aubreystrawb_rny@lizzle_rny @teesocray . God really knew what He was doing with me and all of you today. It really helped me see that beauty is there and I don't have to be so freaking self critical! The pics on the top left and middle left were recent after having surgery and losing about 45 pounds. Bottom left is the day I received my undergrad college degree a little over a year ago and I absolutely glowed from the inside out. And the two right pictures are me at my lowest weight of 227 pounds in a size 16. That was two years ago when I was on Optifast and dropped 192 pounds in 8 months. I hope that I am on a continuing road of a healthier life and so much joy I won't be able to stand it. Since surgery two months ago, I'm down 55 pounds, 120 pounds from my highest weight, diabetes is in remission, normal cholesterol and normal blood pressure. All of that makes me feel beautiful. If I tag you, it's your turn! #beautiful #joy #transformation #wls #wlsjourney #wlsjourney #wlscommunity #rny #vsg #weightlosssurgery #postop #newlife

I received some very lovely and incredibly touching responses.  I am so moved by the wonderful people I have met online who give me support (and vice versa) as I travel this curvy road.  This includes all of you reading this right now. Sometimes I am in complete awe of how blessed I am.  I hope my journey touches someone else as well.  

Weekly weigh-in

My loss for this week was 5.3 pounds.  I can't express adequately enough how great it has been to see the weight coming off.  After losing so much weight on Optifast only to steadily regain a lot of it over time, it has been such a battle.  I desperately tried Weight Watchers and Jenny Craig before again considering getting weight loss surgery.  I was trying so hard and then I'd get frustrated and so I'd eat.  The cycle was so difficult emotionally, let alone the toll it was taking on my poor body.  I have a lot of gratitude with the process I'm going through now.  Some sort of switch has happened not only physically but mentally as well.  I'm making taking care of myself a priority and that's not something I have always done.  I do things like take my lunch with me to work instead of stopping to get something or skipping meals.  I took the extra time to pack my gym bag so that I could head there right after work to get exercise in yesterday, which I did.  Last night when I had dinner out with a friend and I was starting to feel full (granted, just after a few bites of food), I stopped whereas before I would have kept going beyond the point of being comfortable.  As I go further and further out from surgery, I am seeing how differently I am approaching my life. Even my smile is much bigger these days.  People notice it all the time.  They have told me I have a glow about me and they love to see my smile.  Isn't that sweet?  I definitely know I'm in the honeymoon period after the surgery, but I'm not gonna knock it.  I'm just going to appreciate the beauty of each day as it comes, with it's highs and lows.

Weekly Weigh-In

I am thrilled to report that I lost 5.1 pounds this week!  I worked out every single day for that, along with following the surgeon's instructions for this stage after the gastric bypass.  Even better, I'm 102 pounds down from my top weight.  That feels incredibly amazing.  If you've been reading my blog for a long time, you'll know that 420 pounds was my top weight and the time when I started my journey in Optifast.  After losing 192 pounds through that program, I started a quick regain of almost all of my weight, except for about 60 pounds, after I got off of the shakes.  It was a devastating time and I just really felt so lost.  Fortunately, I kept some of my smaller clothes, the ones that were really hard to let go of when I had lost that weight before.  I now fit into a bunch of those, as well as other clothes friends have given me. I'm excited!  By the way, I put a new page on here at the top of the screen with my weekly weigh-in numbers for those who are interested.  This will especially be helpful for those who are pre- or post-op to see how I'm losing each week.

Weekly weigh-in

I'm winding down from a busy but great day.  I lost three pounds this week, making my loss 32 pounds since surgery and an incredible 97 pounds from my highest weight.  Maybe this next week will put me over the top!  That would be awesome.  I know I shared this on my Facebook page and Instagram, so I'm sorry if you're seeing it again, but I wanted to share some side by side photos.  Below left was taken a few months before surgery and the picture on the right was taken today.

A few people commented that I looked younger and happier in my most recent picture.  You know what?  I am happy.  Recovery from this surgery hasn't exactly been the easiest for me, but I absolutely, one hundred percent, do not regret this decision.  I know my journey is just beginning with Katrina (my new pouch), but I already feel a lot better.  Even though I would love to look cute in cute clothes, that is not why I did this surgery.  It was about desiring to have a decent quality of life, to be healthier.  That is what makes me happy.  Now, if I end up feeling more confident and rock the hell out of some jeans, I'll be okay with that, too!

This new life is so weird to navigate at times, I must admit.  I can get so full on just little bits of food.  The more dense the food is, the more full I get on just a little.  The dumping is also something that is difficult to contend with.  I have dumped on tilapia, a thin white fish, twice.  And I have gotten extremely full having imitation crab.  So then I wondered to myself if, in fact, seafood was just not agreeing with me.  Today I bought some salmon to see if maybe a thicker cut would help.  I don't have a bad reaction to shrimp, but I want to expand my possibilities if I can help it at all.  I am so thankful that, yes, Katrina was very happy with salmon.  Here's how little I had to eat when I had it for dinner.

All said and done, that is 1.75 ounces of cooked salmon and a one ounce cup of refried beans.  This is actually on a salad plate, not a regular dinner plate.  I doubt I'll ever be eating with those again!  The more dense fish is a lot more filling than beans.  In fact, that amount of fish made me more full than when I would have an 8 ounce serving back before the surgery.  Who am I kidding?  It probably wasn't even an 8 ounce serving ... it was more likely 12 ounces.  I had so much food before and now my tummy is like a baby.  I'm definitely not complaining, but it's just a different reality for me these days.  When I got the fish, I went to the seafood section in the supermarket and got fresh fish.  I asked the man helping me if I could get roughly one and a half pounds of the salmon.  When I came home and cut it up for meals, it made enough for me to have twelve meals.  That is how tiny Katrina is!

As part of having a healthier life, I am pursuing more treatment on my back because I have been suffering from chronic pain there and in my left leg for quite a few years.  There's a point where you just say enough is enough already.  I'm there now.  So this morning I had an appointment with my physical medicine doctor and then with my physical therapist right afterwards.  The doctor gave me an exam and feels the damage may be weight related and it may also be muscular.  She gave me several cortisone injections in my back.  I'm talking about six or so.  She wanted to cover the entire area that hurt and, to be fair, she did warn me that she was going to do that.  No matter how much you're prepared, though, it still freaking hurts.  She also prescribed a topical cream for me to apply to the area three times a day.  I have to wait for that to come in because it's some sort of compound that they have to special order.  Afterwards, the physical therapist gave me stimulation through a tens unit on my back.  It felt amazing.  So I'll be doing that at home, in addition to exercises to strengthen my back and leg.

As a person who is always taking care of other people, it's sometimes very difficult for me to do things to take care of myself.  Yet, I know it's time to do that.  My health has to be a top priority.  So if that means I need to do more things to care for my body, then that's what I will need to do.  Without even realizing it, I'm doing things throughout the day that fits in the category of self-care.
I logged these miles into my Fitbit today without even realizing how much I was doing.

It's the most I have walked since having the surgery.  And it felt amazing.  I wasn't feeling pain on my sides from my incisions like I have been these last several weeks in recovery.  It just felt nice to be active and know that every action I take towards my health is a win for me.  Like I said, I feel happy and I'm just going to roll with it.

Dumping, doctor's appointment and weekly-weigh in

I have had a very interesting week.  I have thought so much about doing updates here, but it didn't happen.  I've been trying to take recovery day by day.  The pain that I have been feeling on my left side under one of my incisions has been feeling a whole lot better.  Every time I would walk for more than 10-15 minutes, the pain would be excruciating so I'd have to stop.  Then one day, I tried walking again and it didn't happen any longer.  So I've been trying to increase my exercise little by little.  Some days I do great and other days I do feel pain so I know my body is telling me to not push it.  Overall, the healing is going well, especially given it was major surgery.  I often forget that I had a huge operation.  When I look down at my tummy, I see five very small incisions.  It blows my mind a little bit about what went on underneath.  I still can't watch a video of the surgery.  If it's animated, that's fine but I just can't watch a live procedure.  I know what went on, but I'm a bit squeamish with watching an actual operation, even more so when it's my own body.

On Friday, I had my first dumping episode.  If you're easily grossed out, you might want to skip to the next paragraph because I'm going to describe what happened.  I know there are people reading this who are thinking about surgery and it's only fair that you know every part of it.  Besides, I don't ever want to forget what I went through.  Friday was the day that I was allowed to add seafood into my diet.  I decided to get a mild white fish, tilapia.  I looked online to figure out the right temperature to cook it so that I wouldn't dry it out.  Everything went fine in terms of that.  I had a very small amount with a little bit of dipping sauce so that it wouldn't be dry.  One of the things we are warned about is to make sure our food is moist.  Otherwise, our pouches may not be very happy.  I had dinner and everything was fine, but I did have a very small amount because I was worried about adding fish.  Later on, against my better judgement, I had a little bit more because I felt hungry still.  People say you're not hungry after surgery, that it's head hunger.  Um, no, not true, at least not for me as well as other people I know.  I get hungry.  Anyway, I took some leftovers out and put it in the microwave for a few seconds so that I wouldn't overcook it.  I then put a tiny bit of guacamole on it to make sure it was moist.  I read specifically about guacamole on a bariatric eating website, so I decided to follow their lead on that.  I had the fish and didn't notice anything unusual.  A few minutes passed and then I started to feel this incredible pain in the middle of my chest.  That's when the burping started.  I couldn't stop burping no matter what I did.  Next the area where my tummy is started hurting.  I don't know if it was the stoma, the pouch or my actual stomach but all I know is that it was very painful.  I was actually doubled over in pain.  I was rubbing my stomach and that didn't help at all.  I couldn't sit still, so I started pacing around my house.  That wasn't helping because the pain was all over my body by that time.  I was nauseous, shaking, sweating and felt so sick.  I hate to throw up.  I'll do anything to avoid it.  However, by that time, I was calling on the name of Jesus to help me.  I proceeded to throw up seven times.  Every time I thought I was done, I'd have to run back to the bathroom.  I was so upset and I was all alone at home. This all started at about 9pm and, by 1am, I finally decided to reach out to the doctor on-call for guidance.  I wasn't sure if I should drive to the hospital, which is about 35 minutes away, or what I should do.  I could have reached out to family or friends, but I was afraid to wake people up.  I know, it's silly now when I think back to it, but that's what was going through my mind at the time.  When you can't breathe normally and you're trying not to panic, weird things go through your head, that's for sure.  The doctor told me to go back to clear fluids, even if that makes me throw up more (which it did), and then return to things like yogurt to eat the next day.  Eventually, by 3am, I felt like I could finally go to sleep.  Since that time, I have had two other dumping episodes, one yesterday and one again today.  When I look at the common denominator, it's all food that have been leftovers in the fridge that I have reheated.  The first was the fish, yesterday was cream of wheat and today was an egg muffin (egg made with cheese in muffin tins).  So my lesson here is that I can't reheat certain foods in the microwave, even when I add things to them to make them moist.  There's just too much danger of things getting too dry.  The only exception would probably be canned foods that haven't been cooked or soup.  Dumping is not pretty, but this is the reality of negotiating with a new pouch.  Some things will go down well and other things will not.  I thought I'd have to worry only about foods that were high in sugar or fat, but I guess there's no textbook definition of when it happens to each person.  It's trial and error.

Okay, enough of that!  I saw my primary care doctor on Monday.  It was my first time visiting her after the surgery.  She came in to the room and just beamed at me.  I'm now officially off of every single medication except for my anti-depression pill and a cholesterol pill.  She thinks I may be able to pull off of that soon, too.  The swelling I used to have around my ankles is gone.  My blood sugar readings are normal on their own now.  And my blood pressure is 117/64, so that med is gone, too.  I have lost 29 pounds since the surgery three weeks ago, 94 pounds from my highest weight of 420.  She told me that I am going to be the poster child for a gastric bypass success story.  She just couldn't stop smiling and she even told me she's proud of me.  That made me feel like a proud little girl!  She likes me, she really, really likes me.  This doctor has overseen my care for about 15 years, so she's seen me through the worst of it.  She knows how hard it was for me to decide to pursue surgery, but she has been 100% supportive the whole way through.  I did tell her I've been frustrated because I seem to have been in a weight-loss stall for the last week or so.  I lost 21 pounds the first 10 days and then everything seemed to come to a screeching halt.  She reminded me that this is a process and that I am still going down, so I don't need to worry.  I did lose a couple of pounds this week, so I'm clearly not stopped all together.  I am trying to weigh in only once a week, but oh my gosh that's so hard for me.  I finally gave in and weighed myself this morning after only a couple of days.  I feel like I'm more obsessed with knowing the number when I don't weigh myself versus when I just do it once in the morning and then go about my day.  I don't live by the number on the scale, but it just tells me where I'm at and keeping me accountable, even with little fluctuations.  Who knows, maybe in time I can let that stuff go.  For now, though, it is what it is.

Okay, this was a longish post.  Sorry about that.  I need to get back to posting more often.  I have been also posting short updates on my Instagram account.  If you want to follow me over there as well, my username is @misskathyjean.  Don't worry, I'm not letting go of this blog.  It has been an important part of my journey for several years and it will continue to be.  I just find support in many different ways.  The Instagram community of weight loss surgery folks is pretty amazing as well.  I have also found some gastric bypass groups on Facebook and on MyFitnessPal that have been tremendous in addition to amazing friends who are traveling on this road with me and just those that support me as a whole.  Between that and the support of you wonderful readers, I feel more than blessed.  I feel humbled and honored to have met such incredible people.  It takes a village!

Weekly weigh-in

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

Finished my pre-op classes and weekly-weigh in

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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!

Pre-op class #18, weekly weigh-in and still breathing

I know I haven't posted in a week.  My apologies but I've been pretty crazed at work.  We only have a couple of weeks before our kids graduate and I am in charge of our senior awards ceremony so it keeps me very busy at the end of the school year.  I am remembering that there is light at the end of the tunnel, though.
My weekly weigh-in on Monday was not great.  Although this is not a huge amount, I gained two pounds.  Boo. I have been slacking off in logging in my food and I need to turn that around.  I've also not exercised as much as I would like.  I've still got my Fitbit on, so you can see my miles and steps in my Twitter-feed on the right side of the screen.  Some days it was still 10,000 steps or more a day and other days ... not so much.  Powering through though.  I'm not going to beat myself up over not being perfect.

During class, we did talk about nutrition after the bariatric surgery but we also spent some time talking about anger.  One of the things I love about the pre-op classes through Kaiser is that we're not just going over the semantics of the surgery.  While that is important, it's equally as important that we deal with the emotions behind overeating.  I know the surgery is just a tool and it is wise for me to always remember that.  While another classmate was reading a section on anger out for us all to follow along, something triggered memories in the words:

• Anger is a warning signal that my boundaries (physical, emotional, intellectual, etc.) have been transgressed and that something needs to be done.
• Anger is an emotional response to internal and/or external conflict.
• I may have been taught that to feel anger makes me a bad person.
• Anger is a survival-based emotional response that can be recognized, modulated, and constructively used to deal with internal and external conflict.

The memories that were popping up for me were from when I was a kid and I was being physically abused.  I didn't go to anger ... I went to fear.  Each and every time it was about fear.  In fact, I can't even remember to this day going to the place of anger when it came to all of that.  Those are the same feelings I had when I was raped at 13.  I have never gone to that place of anger about any of that.  I lived in fear and worry.  After the reading in class had stopped, our facilitator asked if we had questions or comments and I couldn't help but raise my hand to express what was going on for me internally.  As I was talking, it made perfect sense that I went to food to help me escape.  Where does a child go when they experience those sorts of things when there is nowhere to run and no one to tell?  Of course there were people around me that could have helped, but I guess not in my fragile mind.  Instead, I crawled inside of myself and escaped to a world of cookies, ice cream, donuts and really anything else that could help me not feel.  If it wasn't food, then it became other outlets later in life, like relationships with men I should have never been with.  My God, when I think about the stupid stuff I did with men, I'm amazed I was never hurt.  Of course, I hurt myself emotionally, but I think you know what I mean.  If it wasn't that, then it was back to the food again until I was in a never ending cycle.  

Oh man, this is hard.  Maybe this has something to do with me being buried in work this week, not posting here, being lax on logging my food in and not getting as much exercise in.  That thought just hit me like a ton of bricks ... maybe it all relates.  Don't get me wrong, I'm really busy this time of year at my job but I have to be honest with myself and ponder whether I'm escaping.  Even though all of that has gone on, I am in a really good place today and I'm definitely grateful for that.  My mom is coming over later so we can have a little barbecue.  It's an act of God for sure that we can even have a relationship today, especially as loving and wonderful as it is now.  It's totally the opposite of what it used to be and that is a miracle.

Pre-op class #16, weekly weigh-in and thrown for a loop

I have a deep suspicion this post is gonna be a long one - a lot has happened since my last post.

First off, thanks so much for your sweet messages from my last post.  Reflecting on my experience with cancer has really helped me actually be very centered for things that happened Monday and Tuesday.  Looking at my own scar from my back seems pretty surreal.  Most of the time, I forget the scar is there unless I'm having pain from the scar tissue, which tends to be on a regular basis, or I catch a glimpse of it.  Regardless, I'd rather have the scars than cancer.

On Monday was my regular pre-op bariatric class.  I was a tinge disappointed with my weigh-in results this week, having lost two pounds.  I have to keep reminding myself that all of the losses are adding up, so it does not have to be a gargantuan number.  In fact, even though our goal is to lose ten percent of our body weight before going in for the surgery, the doctor who approved me said I'm okay if I don't lose weight but I just shouldn't gain any.  Besides, these additional two pounds brings me down to 77 pounds from my heighest weight.  So, I'm reminded that the bigger picture is the most important piece of this.

We're done with week 16 now, which was about post-surgery exercise.  We have just eight weeks left.  Wow!  We discussed the things that we can start doing now to ensure as much success as possible after the surgery.  For this week's class, our regular facilitator wasn't there so our structure was a little different with a sub.  This class was particularly odd because a stranger just happened to walk into our room by accident.  The place where our class is situated is in a corner room, so most people don't come there unless they are specifically looking for it.  It turns out that she was looking for a person in one of the classes, but it was the wrong time.  This person, though, had bariatric surgery six months ago.  We took the opportunity to ask her questions while she was there.  It was pretty funny because she stood in front of our class for about 45 minutes and gave us an impromptu talk on her story.  She had gastric bypass surgery and we haven't had one of those speakers yet, so we threw a million questions at her.  She was a great sport, though, because she answered every single one and even ended up showing us her tummy to let us know what the incisions looked like.  Imagine that ... a complete stranger lifting her shirt and showing us her tummy.  I loved that!

Prior to her walking in the room, I was one hundred percent all about the sleeve.  I had my mind made up that it was going to be the surgery I would select when it was time to let the surgeon know my decision.  There was absolutely no question in my mind. Then she shared her experience and I sat there almost in stunned silence because I was seriously starting to question my decision.  I know that everybody has a different story.  Some people have a great surgical experience and some are not so great.  I know that deep down inside, especially with all the research I've done and talking to various people online.  I have a good friend that had the bypass as well and I will often throw random questions her way.  She very sweetly answers them every single time [thank you for that my love!].  With the telling of her story, the person who happened to walk into our class told us about the fact that she had no pain from the surgery, no side effects, being able to be more active with her kids and so much more.  She also talked about the difficult parts, like mourning over not being able to eat certain foods and having an episode of dumping.  Yet, she kept saying, "You guys will be fine, you'll be just fine."  No matter what difficulties came up, she reiterated that she had absolutely no doubts about her decision and wished she had done it sooner.  I listened to her story and I thought to myself, "Gosh, that doesn't sound bad at all."  I keep wondering what I was so afraid of with the bypass.  I listed to her, asked questions along with other people and left there feeling struck with a million more questions inside.

What have been my issues with the bypass?  Well, for one, the malabsorption that occurs is a concern.  I thought about the fact that I would have to take supplements for the rest of my life.  I never went to the place of consideration that I'm already taking medication, so what's the big leap?  If I don't take my insulin, for example, I'm pretty screwed.  Then the idea of having my intestines moved around scared me.  What if they surgeon makes a mistake?  What is my course of action at that point?  It's a permanent surgery and my system will be forever changed.  Okay, that's a valid concern.  I also had thought a lot about stories I have heard of people gaining the weight back and other possible complications.  I was forgetting that the sleeve comes with its own potential issues.  Yet, that stranger's talk was replaying in my head and I wondered if perhaps I was closing my mind to at least being open to looking at the other side more.

The next night, which was last night, I had the infomation session with a surgeon at Pacific Bariatric.  It is a requirement for us to go to at least one information session prior to being referred for surgery.  With the discussion from the previous night replaying in my head, I reminded myself that I needed to have an open mind and be as honest with myself as possible.  As I drove up to the hospital, was incredibly nervous.  As I looked at the buildings, I was hit with the realization that my life would be changing forever in one of those rooms in just a few months.  Holy crap!

Our session was in the auditorium of the hospital.  I chose a seat right in the front.  I work in education, so I always rationalize to myself that I'll learn better if I'm sitting in the front.  I sat literally in front of the doctor - no better seat than that as far as I'm concerned.  I must say that he was absolutely amazing and I hope I can choose him as my surgeon.  He had an incredible bedside manner.  He was personable, spoke concisely, educated us and made himself available for absolutely every question the audience threw at him.  His approach to the issue of surgery was to first help us understand about the nature of obesity.  He didn't just stand in front of us and tell us we were overweight because we ate too much.  He came right out and described how obesity is a disease.  He talked about the factors that go into it, such as genetic, environmental, psycho-social and more.  I wanted to get up and give him a big hug because I felt like he "got" it.  This isn't just about this particular surgeon, but the entire Pacific Bariatric practice.  The approach was much more than just about the surgery itself, reminding us that this is not a diet but a new lifestyle.  Many doctors do judge patients who are overweight.  Yes, they are quite caring, but I can't tell you how many times I have been looked over and judged by the medical community for my weight.  I didn't feel that at all last night.  I just can't express enough how absolutely impressed I was with the talk.

Because I had such a primo seat, I was able to really pay attention when he demonstrated how each of the surgeries work and what our bodies look like internally before and after.  I wanted to focus, so I didn't take any notes until I got home.  This is such an important decision in my life with such a major surgery.  It is going to affect the rest of my life, so I wanted to be present enough and open enough to hear everything.  In my mind, I was really starting to focus more on the bypass and less on the sleeve, just like I had in the impromptu talk the night before.  As a diabetic patient who has sleep apnea and other issues, I needed to know what was the right choice for me.  As if reading my mind, the discussion started going in that direction.  The doctor told us that, when we meet with a surgeon, we will talk about all the options and select the one that is going to serve us the best in terms of long-term success for our specific needs.  My surgeon will not be telling me which surgery to have, but he will be giving me his recommendation as we discuss my options together.  There were a couple of things that really stuck out for me:

• If a person has a severe case of diabetes and is taking insulin, they recommend the bypass.  While it is possible to go into remission with the sleeve, the chances are much better with the bypass.  I knew this, but the doctor was pretty clear to say that those on insulin benefit much more with the bypass than those just taking oral medications.
• If a person has more than 150 pounds to lose, they recommend the bypass.  While people can lose a lot on the sleeve, and many have, the chances for losing all my excess weight and getting into a healthy BMI range is great with the bypass.  The very idea of being in a healthy weight range brings tears to my eyes. 
• The rate of complications is very low with the bypass.  Their statistic is that one patient in every two thousand, or .28 percent, may have a complication.  In the over 16,000 bariatric surgeries they have performed, only four had to go in for revision surgery because of a complication.  They have only had one death and that was not related to the surgery, but it did happen a month after it was performed.  In fact, they are a center of excellence and have the best morbidity rate in the nation.  In the nation.  
• There is thirty years of data that backs up the success of the bypass versus no long-term data for the sleeve since it has only been around for nine years.  This does not mean the sleeve is not a great surgery, but there just simply is a lot of history with the bypass.

If you haven't figured it out already, I am seriously considering the bypass again after the talks on both Monday and last night.  I believe in my heart, stronger than I can ever express in words, that it was God's hand at work that our visitor appeared in class on Monday.  Had she not come in, my heart would not have been as open to the possibility of the bypass in yesterday's information session.  His hand was at work as well last night with such an impressive surgeon.  I am praying that I continue having an open heart and a willingness to search my soul for the truth of what is going to be the right decision for me.  At the end of the day, the decision is going to be mine and mine alone.  Clearly I am going to take everything into consideration, but I also know that I have to be honest with myself.  Don't I want to give myself the best opportunity for long-term success and  the possibility of a healthy, long life?  Of course.  

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 #14 and weekly weigh-in

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

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

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

Water Challenge Day 87:  Drank 178 of 174 ounces

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

Pre-op class #12, weekly weigh-in & seeing my therapist

Last night was class number 12 of my pre-op bariatric classes through Kaiser.  Hooray, we're halfway there!  I find myself looking forward to the classes every week, not only because of what we may be talking about but also because my fellow classmates are an amazing group of people.  We had a speaker who shared her experience of having the gastric sleeve done about a year and a half ago.  She even revealed her stomach with the excess skin.  For some people, that might have been discouraging since it seems most have a huge hope that they will be the person who does not end up with loose skin.  With the amount of weight I need to lose, I am realistic and know I will be sporting excess skin.  But I look at it this way:  would I rather have excess skin or a round body that fills up all my skin?  Besides, I lost 192 pounds before ... I know exactly what my body looked like at the time.  My tummy wasn't bad at all compared to my thighs.  I had major excess skin there.  Yet, I accept it for what it is and would gladly have that problem versus being overweight and unhealthy.  My whole thing with having the weight loss surgery has been about quality of life issues.

In terms of my weigh-in, I lost another two pounds.  Yay!  I'm happy to steadily be going down, down, down.  That's a 16 pound loss since I started the classes, which I will gladly take.  During my Spring Break this week, I have been trying to stay as active as possible.  This morning, for example, I decided that I was going to go to one of our local lakes that has a five mile course around it and get a good walk in.  It's been hot here, in the 90's, but I figured that since I was walking in the morning, it wouldn't be so bad.  I wasn't intending on walking all the way around the lake, but maybe doing about three miles or so.  How bad can exercise be when there's such a pretty view?  This is a picture of part of the lake on the right.  As I parked my car and prepared my gear for the walk, I thought to myself, "Hmm, feels a little warm."  Despite how pretty it was, I was sweating in a matter of a few minutes and decided to turn my shrinking butt around and head back to my car.  It was just way to hot for comfort (I found out later it was 95 degrees).  I did a mile there and then decided that the air conditioned comfort of my gym had my name all over it!  I ended up doing three more miles on the treadmill with the cool air surrounding me.  Ahhhh.

Prior to my class yesterday, I had a session with my therapist.  Man, that was incredibly emotional.  I'm one of those people who refuses to lie to her therapist because, really, what's the point of that?  When I get honest, especially about things that I carefully avoid talking about to other people, the emotions seem to smack me in the face and leave me feeling incredibly vulnerable.  One of the first things we talked about is something that has been bothering me for quite some time.  In the last year or two, my fear of heights has gotten to a debilitating level and it's really concerning me.  I've always had a fear of heights, ever since I was a small child.  Lately, though, it's crossed over into almost a terror feeling.  I will avoid heights, no matter if it's a few feet off the ground or several stories.  I think it's not even about the height necessarily but the fear of falling.  I was recently walking with a friend on a very small bridge and told her I had to turn around.  When you look at the bridge we were on, you would probably question my sanity because it was not that high at all.  It's just an awful feeling for me inside.  My heart starts racing, my legs become rubbery and I go into a panic attack.  It's a horrible feeling that I can't really describe well, but it is a true fear for me.  Suffice it to say that I avoid heights at all costs.  It's been bothering me a lot, though, because I feel absolutely disabled by it.  So we're going to start treatment in regards to that.  I know this means that, through the therapy, I will likely eventually have to get back on a bridge or some such thing.  I'm tired of avoiding it, though.  There are things I simply won't do because heights are involved.

The other half of the session focused in on the issue I described in my last post - feeling "less than" and body image.  Thank you to those who were so sweet to leave me a message.  We really delved into my history with men, from being raped, having a period of high promiscuity to even how things ended with my ex-boyfriend.  I was in absolute tears talking to her.  It's not as if I'm planning on looking to start a relationship right now.  With my preparation for surgery, I have a lot on my plate and getting involved with someone is not something I want to do.  Can you imagine dating and having to explain why you're only eating tiny bits of food or somehow experience "dumping" in front of them?  That would be incredibly embarrassing.  The feelings that I'm going through right now are more about loving and accepting myself now.  We definitely are our own worst critics, me included.  I don't want to look in the mirror and think of myself as an ugly, unworthy, hideous human being any longer.  That's not fair, to myself or anyone else that tells me I'm opposite of that.  I even had a man checking me out several times at the gym today.  If that's not a boost, then I don't know what is!  These are feelings I don't verbalize with other people, but I do want to be able to get to a point where I can appreciate myself in the same way others do.  I don't want to constantly stare in the mirror and tear myself down.  So I'm bringing these feelings out and talking about them with my therapist.  She told me she wants to see me more often, which I'm happy to do.  I want to move past the self-criticism into a healthier existence - body, mind and soul.

Water Challenge Day 75:  Drank 180 of 178 ounces