Working it

Things have been going well.  Both my father and brother are out of the hospital, thank you, God.  My father now has about two months of recovery at home before they re-do the hip replacement.  He is in very good spirits and has such a positive attitude.  I respect him so much for having the strength to get through everything he has been dealing with without breaking down.  He had a hip replacement that got infected, had the hip replacement removed, a spacer inserted, has been in the hospital six separate times, rehab for the last six weeks or so and then has to have the hip replacement redone.  My brother has been put on new medication and they are hoping this will work instead of having a new heart transplant done.  If not, he will go back on the list in a few months.  I continue to pray daily for my family.

I started working with my personal trainer.  She is just so awesome and it was such a great decision on my part.  I'll be working with her for three months.  We will be checking my weight and measurements every three weeks.  I shared with her my experience of having weight loss surgery and my attempts of weight loss.  She was in awe of me and actually told me that I was an inspiration to her.  Wow, I had to pick my jaw off the floor.  I started a separate page on here for all of my strength training workouts if you'd like to follow along or at least get the benefit of a personal trainer without having to pay for it.  There's a link for it at the top of the page.  I'm doing things with her that has taken every ounce of courage to do in the middle of the gym.  When people work with personal trainers, others in the gym watch.  It's a very big gym so this isn't easy.  One time I was doing cardio while she was training someone else and I swear every pair of eyes was looking in the corner where she was doing the training and watching.  Yet, I don't let that stop me.  I've even done weight lifting in the section where all the men with muscles do the majority of their work.  What's been interesting for me is that they are not looking at me and mocking me for being the fat lady trying to work out (which is what I had envisioned in my mind).  Instead, they are looking at me and smiling, even checking out my legs when I stand in front of the mirror focusing on my form.  It's been so weird!  I almost feel, dare I say, normal.

I also have seen the dietician at Kaiser's Positive Choice center, which is part of a service I can employ after surgery for help with my nutritional needs.  I just have been feeling weak and lightheaded.  I wanted to make sure that I was doing the right things for my body with the increased exercise.  When I work out, I'm burning about 900-1100 calories a day with just exercise.  Given I was eating 800 calories a day, it makes so much sense that I was feeling the way I was.  The dietician told me that 800 calories a day is just not enough for a person that exercises as vigorously as I am.  He did a mathematical calculation based on how many calories are in protein and what I was taking in each day.  He told me to increase my calories to 1200 per day instead of the 800 my bariatric surgeon recommended.  He understands where the doctor was coming from, but we do need to take into account how much I'm burning during workouts.  When I asked him how I should increase the calories, he said it is as simple as making sure I'm getting enough healthy fats in my diet such as coconut oil or almond butter.  He also told me I need to take in 100 grams of protein per day now with the increased calories and to ensure I am hydrating enough.  He stated that I should try to get in as many fluids as possible earlier in the day but to shoot for at least eight cups.  He also agreed that the strength training I'm getting with my trainer is especially valuable in dealing with excess skin and having a toned body because we can lose a lot of muscle mass with significant weight loss if we are not also incorporating strength training.

So, my friends, I'm working it and taking good care of myself.  It's a long time coming, that's for sure.

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.

Feelings of grief I think

Today was incredibly painful for me.  Not physically, but emotionally.  I shared yesterday that I was given some potentially devastating news in terms of my graduate program to do school counseling.  I had so many unanswered questions that I decided to send a message to the personnel department to figure out what's going on.  To do the field work required for my master's degree with my district, I have to do it 24 hours per week over three full-time, 8-hour days for the duration of about a semester or so.  I will have to take a leave of absence during those days from my 40-hour per week job.  I am not permitted to do the hours during the summer.  Then, when the time comes to apply, I will have to quit my job and do counseling in another district for a minimum of two years before I will then be allowed to come back and counsel in the district where I have been working for 24 years.

The biggest problem I have is that I already work in the counseling department of a busy high school.  None of the years I have matter, though, not where this is concerned.  I have given so much to the district where I work.  I'm a product of the district and love the work I do.  All I want is to be able to have the opportunity to become a counselor, but that opportunity is just not there.  Not only that but I will have to quit something that I have been invested in for so long.  I have accrued so much time towards retirement, benefits and more. If I leave, that means I will probably have to also leave my doctor because my insurance will likely be through another provider.  It's just very, very difficult to deal with this.

Thankfully I work with some fantastic friends who helped me to look at the bigger picture.  If counseling is important to me, yes perhaps it may not look like what I thought it would but that might also be a blessing in disguise.  I just won't know until I stick my neck out and take the risk.  They are absolutely right ... the point is to be working with kids.  There are no guarantees with anything and so I have to walk forward in faith.

I do have a strong faith, but being a human being is also hard when we often times have fear.  Right now I have a lot of it.  I shed a lot of tears today over this, but I have been incredibly supported by so many people.  My supervisor reminded me of something that fits in with this situation just perfectly:

Be still and know that I am God.  That means I'm not in charge of the outcome.  In fact, I'm in charge of no part of any of this process.  I am responsible for doing my part, but after that it really is out of my hands.  As the day went on, the tears were less and less.  I went from sort of throwing my hands up in the air to stepping back, taking a breath and saying to myself that this is really going to be okay.  Obviously there are so many other battles to fight out there.  I'm not discounting how I feel, but just to get some perspective.

In other news, I received a call from the Positive Choice clinic to schedule my pre-op classes.  That was super fast!  I just saw the doctor yesterday and they were already calling me.  Unfortunately, I missed the call so I won't be able to schedule until tomorrow morning but at least I'm on my way.

A few weeks ago, I completed a sleep study with Kaiser for the sleep apnea.  I received a report in the mail today regarding the results.  I definitely have obstructive sleep apnea and they are recommending the use of the auto-titrating machine (APAP).  The report showed me averaging less than four hours of sleep per night.  No wonder I feel so flipping tired all of the time!  Because of my medical history with this, they do want me to meet with one of the board certified sleep specialists to discuss my diagnosis and any follow-up care I will need.  So I need to make an appointment in regards to that.  I swear, in the last year or two, I have seen more specialists, nurses and doctors for a lifetime.  These are additional reasons as to why I am pursuing the bariatric surgery.  While it's not a cure for all that ails me, it will most definitely help and that's all I've ever really wanted - to just feel healthier.

My highly stressful day

I had a whirlwind of emotions today and I'm still trying to process them.  I have mentioned before that I'm in the process of applying to graduate school.  My goal is to participate in a master's program that will lead to a school counseling position eventually.  I currently work in the counseling department of a big high school.  I love what I do working with kids, so this is just a natural progression to the next step up for me.  I've actually worked in education since I was 17 years old and now I'm 42, so I definitely have a lot of experience.  Nothing can prepare me more for this than what I'm doing now, getting day to day exposure of what happens in high school counseling department.

So I was talking to a colleague who is currently in a graduate program for the exact same thing.  She's about a year in and mentioned to me today she found out that if I want to eventually become a counselor in our current district, my practicum and field hours must be performed three full days per week.  The program requires a total of 600 hours doing that.  Given that I work full time, 40 hours per week, and I would be participating in a full-time graduate program with classes taken at night, I felt like I was sucker-punched.  A friend of mine called her contact at our district office and the person confirmed that I must do three full 8-hour days or I could possibly petition to do four 6-hour days.  Regardless, it must be a minimum of 24 hours per week and they don't want it split up.  The district's rationalization is that interns don't get to experience the full scope of what happens in a counseling department if their time is split up to just mornings or just afternoons.  I do understand that logic, but I already work in a counseling department!  If I choose to do my hours outside of my district, they basically won't hire me.  One of my friends, who is a current counselor and is supervising two interns right now, told me that her interns said the district won't hire you unless you have counseled elsewhere for two years first.  If I do end up counseling somewhere else, I likely will not be returning to my district unless there's a compelling reason to do so because it will be a huge deal to leave my district in the first place and I probably won't want to leave another place.  Never say never, though.

I was pretty upset at all of this news.  I wasn't even at the point of wanting to cry over it.  I was pissed.  The graduate program itself is completely flexible and will let me complete my hours part time or in any way that works out for my schedule.  The issue is with my district and their strictness with those 24 hours.  Am I supposed to take a leave of absence?  Am I supposed to somehow make up those 24 hours somewhere?  It's not as if I don't have any exposure to kids and everything is theoretical for me ... I work with kids everyday and often do many things that a counselor would do.  Granted, I do not handle crisis counseling because there are legal issues around that, but there are often crossover duties.  I did decide that I'm going to contact the personnel department and talk to them about my concerns.  My friend that told all of this to me today is a teacher, so the way things will work out for her schedule-wise is different than my situation.  Regardless, though, we both have to face the fact that, if we move forward in the programs, we will have a huge cut in pay.  I'm a single person who has no other income than my own, so I'm faced with having to make some very touch decisions to survive on 16 hours per week of pay.  Excuse my language, but fuck!

With all the stress of that churning in my stomach, I had to leave work a little early and then head to my appointment at Kaiser to meet with the program doctor who would be reviewing my test results and discussing whether or not I would be officially accepted into the program for weight loss surgery.  I didn't know what to expect, so I was feeling anxious with butterflies churning in my tummy.  When I checked in at the Positive Choice clinic, I was asked to weigh myself and then have a seat to wait for the doctor.  I have gained a couple of pounds.  I didn't know if that was a true gain or because I had been drinking water all day, which always adds weight.  I got recorded at 371.5, which was pretty difficult for me.  My lowest weight I got down to when I was doing Optifast about a year ago or so was, I think, 220.  As I sat there waiting, I had to remind myself not to beat myself up over the number because I'm there to get healthier, not berate myself.

The doctor came and got me and brought me back to his office.  I looked around and noticed all of his diplomas, awards and news articles about weight loss and surgical options on the walls.  There were drawings of the differences between the different weight loss surgeries as well.  He began by discussing my current BMI, which is calculated to be about 54.  He said the program requirement is to have a BMI of 40 so I more than qualify on that front.  Fantastic Kathy (can't you detect the sarcasm?).  Then he started asking me about my diabetes, whether or not I inject insulin, my osteoarthritis, the pain in my legs and fibromyalgia, my history with high blood pressure, sleep apnea, depression and all the medications I take.  He told me I am an excellent candidate and congratulated me since he is approving me for surgery.

Hoooooray!!!

All the stress of the day went away in that moment.  I am now officially on my way.  He does recommend the gastric bypass surgery for me since that is the one where I can lose the most weight and most of those patients have their diabetes go into remission.  He did explain that my diabetes will never be reversed or go away, but the remission will make it so that I won't appear to be diabetic any longer as long as I follow the program.  When I discussed with him the difference between the gastric bypass and the vertical sleeve, he said the sleeve does not allow for as much weight loss and the not as many patients have remission of their diabetes.  The lap band does not reverse the diabetes at all.

The next step is that one of the nurses will be contacting me in about a week to put me in a class.  Since Carrie and I want to do the class together, I'll be choosing the one that is closer to where I live.  The only bummer is that it doesn't start for another month.  However, unless they have a class starting this month, that's the one I'll do.  The doctor did say that about a month before the six-month pre-op classes are over, I will be contacted by one of the surgeons at Pacific Bariatric to meet with them.  The surgery will happen about a month after I finish the classes.  That will bring me into about mid-August in terms of having the surgery.  The doctor did say that I will be in the hospital for two days to make sure I don't have any complications develop and then I should be back to work within two weeks since I don't have a highly physical job.  He did tell me that, in terms of my weight, we want to aim for me losing about ten percent of my body weight prior to surgery or at least maintaining where I'm at right now.  They don't want me gaining but staying the same is okay, too.  So here I go!