"So Why Do This?"

After the list of the changes that I'll have to make, some people may be wondering, "So Why Do This?" Oh, there are so many reasons! How much time do you have? LOL Here's a few:

1. I have an aneurysm in my ascending aorta (currently minor but still a terrifying prospect) and it would be better for me if I can keep my blood pressure under control (something that's easier to do when you're not drastically overweight)
2. I have hypertension
3. I have PCOS
4. I have insulin resistance (common w/PCOS)
5. I look in the mirror and the body I see does not reflect the person I am (and I hate it!)
6. My joints hurt from the excess weight and I'm in pain (granted, usually minor) all the time
7. I have tried literally everything to lose weight - up to and including Dr. Rx'd medication - and I've only lost 25 lbs.  That's less than 10% of my body weight.
8. I've seen first hand what years of obesity does to a person's quality of life (my mom)
9. One of my best friends from high school died 4 years ago at the age of 35 from a heart attack secondary to obesity
10. I want to have children and getting pregnant at my current weight with my current health conditions is dangerous, foolish, and dangerous.

I could go on, but that's a good start. I'm sure you get the picture.

None of these things really answers the question, though, does it? And it's such as simple question! It was posed to me the other day by my friend D and I found myself meandering through the above list, the science of how the surgery changes your body (pretty cool stuff if you're a geek like me), how the weight loss will positively impact the health issues I'm dealing with, and how I really want to have children and to do so at my weight is akin to sending out an engraved invitation to eclampsia and gestational diabetes. But again....does any of this actually answer the question? Not so much.

There's really only one simple, cohesive, coherent answer I can give: It's the best decision I can make for my health. Sure, there are loads of factors that went into making that decision but at the end of the day all that really matters is that I know I'm making the right decision for me and my life.

Vitamins and Blenders

This week I finally got around to ordering the calcium supplement and multivitamin that I'll be taking after surgery and they arrived today. I'm curious about the flavor of the calcium citrate chews, but I only bought exactly enough dosees for the first 30 days after surgery, so I'll have to wait to find out. The multis I've had before...they taste like a chalky orange creamsicle. Yum. *snort*

The real gem out of this shipment is the blender "bottle." It's more of a travel cup, IMO. Whatever you want to call, I call it a paragon of practical design! The lid screws down and the mouthpiece cover snaps in tightly, so you can dump in the liquid and the protein powder, batten down the hatches, and shake it all together. It has a spherical whisk inside - appropriately called a "blender ball" - that breaks up the protein powder as you shake with minimal bubbles, thus largely eliminating the foamy head problem of mixing the powder in a blender. (There were no lumps, either, unlike mixing with a spoon or fork.) I did a brief "antigravity" test (I turned it upside down and shook it for a few seconds) and there was nary a drop spilled, leading me to believe that there are possibilities of being able to prop this upright in my messenger bag with some liquid in it for protein shakes on the go. It's made by Sundesa, is BPA free, has liquid measurements imprinted on the side, and at around $7-$8, it's a good deal.

I may need to buy a few more. I can see this getting daily use.

Too Much of a Good Thing

I'm a little shy of a week into the pre-op diet and as I suspected might happen, I have become rather sick of the protein shakes. It's not that they taste bad - in fact, they are suprisingly good! - it's more than I'm not a big sweets person and never have been. I've always been more of a salt/fat/crunchy person when it comes to food. In the boxing match of chocolate vs. potato chips, potato chips always knocks chocolate outta the ring. So consuming a sweet/fruity type smoothie every day for breakfast is a bit much after a few days.

Yesterday it was freezing cold here (okay....upper 30s, but still!) and overcast and I had a chill in my bones and I just could not face another breakfast of cold/milky/sweet/fruity protein shake . So I cheated. I had an eggwhite omelette with 2 T. of low fat sharp cheddar and half of a pomegranate. Nutritionally it shakes out to around the same calories, a bit less protein, and a bit more fat. Not great, but one meal won't derail my whole world. (I keep telling myself this because I tend towards perfectionism and when things aren't perfect, I have a history of throwing the baby out with the bathwater.)

I put in a call to the nutritionist this afternoon and she suggested that I try the unflavored protein mixed into some plain oatmeal or really anything else I wanted. She said the main point was to keep it low calorie and eat enough protein to keep me satiated until the next meal without snacking. I ordered the unflavored whey isolate protein from Syntrax today from amazon (they have had the best prices so far with free shipping) and it should be here in a few days. I'm looking forward to some experimentation with it...I'm excited to see what the culinary possibilities may be!

Thanksgiving

I wasn't planning on posting today but then decided at the last minute to bring more than just pie to my brother's for the holiday. I've done a simple veggie roast of turnips, carrots, garlic, and lemons (recipe below - if you can even call it that) and my plan is to eat turnips in place of mashed today. I've concluded that one day won't make a huge difference on the pre-op diet as long as I don't go hog wild and part of that plan is that I am following the diet for the first hald the day. To that end, I had a protein fruit smoothie for breakfast and I'm having a frozen meal for lunch. The Thanksgiving meal is set for a bit later in the day (4:00 or 5:00ish) and that will be dinner.

Thanksgiving Veggie Roast

2 large turnips, peeled and cut into 1" cubes
3 heads of garlic, sliced in half
3 lbs. of carrots, cut into 2" chunks
3 lemons, sliced in half
Olive oil
Salt
Pepper

Preheat oven to 400F.

Lightly coat turnips, carrots, cut edges of the garlic and lemons and place on sheet pans so that nothing is too crowded. Roast 30-45 minutes, or until veggies are just tender. Veggies can be served room temperature or easily reheated.

And if you're thinking that roasted lemons sounds weird, trust me - they're divine!

Happy Thanksgiving!

Pre-op Diet Day 1

As the title suggests, I started the pre-op diet today. I don't know that I'll be posting every day of this diet, but the inaugural day seemed worth talking about.

Breakfast was a protein shake made according to the Weight Center instructions: 8-12 oz. low fat milk, 1 serving of whey protein supplement, and 1/2 cup fruit. I used the Syntrax Nectar-Sweet protein shake mix in the vanilla bean torte flavor and opted to add the half cup fruit directly to the shake to make it a smoothie.

For fruit, I used the Dole strawberry/banana/peach frozen blend (just frozen fruit, no sugar added). As a smoothie, it wasn't too bad. The protein mix has a distinct vanilla flavor without being too sweet and the strawberry and banana really shined through.

 

I did notice that the protein mix frothed a huge amount when put in the blender with the fruit and the foam didn't subside after a few minutes, but stuck around the entire time I was drinking the smoothie. The foam isn't a big deal right now, but I think it might be an issue after surgery (I can see it turning into stomach pain pretty easily). I've seen these mixer cups around, though....thinking that might be a good alternative to the blender. I won't be eating the fruit immediately after surgery anyway, so I'll only need to mix the shake with the water or milk.

I have a choice for snack of another protein shake or 1 serving of fruit. I'm thinking an apple might be more satisfying. Lunch and dinner are supposed to be 4-6 oz. lean protein and at least 1 cup of non-starchy veggies. The WC nutritionist also mentioned that I could eat low-cal frozen meals instead so I bought a few. I don't love frozen meals, but I I got them easy lunches...hopefully they don't suck. ;-)  It's almost lunchtime so I guess I'll get to find out soon!

I know it's a bit nuts to voluntarily start the pre-op diet earlier than they told me (and the day before Thanksgiving, no less! I'm cooking for the holiday today and the smell of pecan burbon pie is Killing. Me.) but somehow it just seems to make sense to my brain to insert some order into the chaos of food around the holidays by starting a little early. And I figure that a little extra practice at this whole structured eating thing and my new lifestyle around - well everything - but food in particular, might be a good idea. Sometimes change comes slowly. I have a feeling this may be one of those times.

The Easy Way

While I thankfully have a life full of supportive, loving, people I have occasionally heard comments (not directed at me - even obliquely - but  in social situations and from a few people in university classes) that surgery is the "easy way" to lose weight. To all those people I say: You can salt and pepper my ass and prepare to bite me.

There is absolutely nothing easy about making the decision to put yourself under the surgeon's knife, knowing full well that you will never eat or drink like you used to again. That bears repeating: There is absolutely nothing easy about making the decision to put yourself under the surgeon's knife. Regardless of the reasons or the benefits.

(Notice I don't say that I'll never eat and drink "normally" because, in fact, after healing from the bypass surgery the eating I'll be doing is far closer to "normal" than how I've ever eaten before.) I'm rather looking forward to it, if I'm being honest. Not so much the surgery, or the pain, or the swelling, or the fatigue, or the IVs (ick! I hate the way the IV catheter feels in my arm!), or the liquid diet for 2-4 weeks afterwards...none of that. But I'm looking forward to being more comfortable in my own skin. To not feeling like I'm fighting with my body for every ounce I manage to lose - because that's basically what losing weight with PCOS is like. It's like being Maltese during the seige of Malta while being attacked by the Turkish empire. Hopelessly outgunned and laughably undermanned. In a word: Screwed. Yeah, I'm looking forward to being able to eat reasonable portions, exercise like a human being, and lose weight. Yanno....like "normal" people. There's that word again.

Which leads me to my next bit of business: The weight I am currently. I haven't mentioned it, have I? Hm. Well, no time like the present to come out of the obesity closet.

Height: 5'7"
Highest Weight: 347.8
Highest BMI: 54.5
Current Weight: 328.6
Current BMI: 51.5

Current Measurements: Bust: 53", Waist: 47" Hips 58", R Thigh: 35"

There we go! How's that for the ugly truth of the matter?

I start the pre-op diet on Wednesday (right before Thanksgiving!), so I'll have to wait and see what changes with these numbers between starting the diet and the date of surgery.

Breaking News

This week the Centers for Disease Control (CDC) sent out a notification to doctors and hospitals telling them that after running extensive government-funded ;-)  tests, they have determined that it is possible to measurably lower the incidence of post-surgical wound infection if patients (meaning yours truly) will just deign to bathe in this fabulous antimicrobial soap for 2 days before, and the day of, surgery.

I'm all for preventing infections, particularly in my body, but this is some uninviting - dare I say nasty - stuff. It smells like a hospital and you have to wash with it like you're in the army. That means soak down, turn off the water, scrub with it from the neck and moving downwards all over (except face and the lady bits) for at least 5 minutes, and then rinse off. No washing with your regular soap afterwards. The day of surgery you can't use your regular deodorant, etc. either.

Admit it, you envy me. :-)

Marching Orders

I got my marching orders for the pre-op "liver shrinking" diet this week. I am under the impression that not everyone who goes through this surgery is on a diet like this and it's apparently unique to the docs at the Weight Center. It's relatively simple and focused on rapid weight loss for a short period of time...protein shakes and lean protein and veggies and a small amount of fruit and no sweets, starches, or fats for about 2 Weeks before surgery. I'm given to understand that it's the weight loss effected by such a diet that causes the liver to shrink, thus affording the surgeon more space to maneuver in my gut. And if he wants more space, he's welcome to it! Giving my liver a wide berth with his scalpel sounds like a fabulous idea and if I need to eat cardboard for a month to make that happen, so be it! This diet really isn't that bad. Just because it's healthy and low calorie doesn't mean it has to be low flavor. I'm thinking that some chicken beat marinated in lemon and garlic and then grilled would be very nice. And kale...I could totally do something tasty with kale! I'll let the cooking gears grind away for a bit, but in the mean time, I was thinking that I might start the diet a few days early. Technically, they told me to start it on November 26th, but I'm thinking I might start it on the 20th. I know, I know...go through Thanksgiving on this diet when I don't have to?! Yes. I'm thinking of it as a dry run for life after surgery. Plus, it gives me an extra 6 days to shrink my liver for the surgeon. That can't be a bad thing.

Changes, They Are A Comin'

As I edge closer and closer to my surgical date, the many less-monumental changes that will happen in my life are beginning to solidify for me. I say less-monumental because they aren't the Big Huge changes like the surgery, itself, or the accompanying weight loss. Instead, it's the smaller but more daily changes I'm thinking about. There's a whole list of things that will leave my life for either a very long time or forever after surgery.

Now, I know that there is a lot of controversy and different docs have different things that they tell their patients, but this is what my doc has told me, and I plan to listen.

1. I'll be sipping water from the moment I wake to the moment I go to bed every day, forever, to prevent dehydration (a minimum of 64 oz. daily!)
2. I'll have to take vitamin supplements every day for the rest of my life to fend off malnutrition, anemia, and osteoporosis
3. Quarterly blood draws to ensure appropriate vitamin/mineral levels
4. My (currently mild) lactose-intolerance could very likely get more pronounced
5. No gum (If I accidentally swallow it, I'll end up back on the surgeon's table.)
6. No soda (It can expand the stomach "pouch." If I'm having surgery to make my stomach smaller, I'm not doing anything to counteract that, period.)
7. No alcohol (I hardly drink anyway, so no great loss) - though I've heard from one doc that this is only for the first year, I've also heard from another doc that it's best to just never drink again.
8. No time-released meds
9. Risk of stomach ulcers
10. Smaller portions
11. Very few sweets, fats, and carbs - a diet emphasizing veggies and protein
12. A more active lifestyle with daily exercise

I'm sure I'm forgetting stuff or there are things I don't know about yet, but that's quite enough all on its own, isn't it? Deep breath. I can do this.

That Was Fast!

I ordered a MedCenter from Amazon on Friday and it arrived this morning!

It's monstrous, isn't it? It's takes up about 12" of real estate on my counter, but the organizational benefits outweigh the space costs. I'm a visually oriented person and having a Big Visual Cue to take my vitamin supplements every day after surgery (and for the rest of my life) is perfect. I like that it allows me to fill a month at a time and I can get my meds filled for 90 days at a stretch ( 90 day Rx = fewer copays) and I can buy my vitamins in giant bottles and I'll know way ahead of time if I need to order refills. Each red square is actually the end of a tube (one for each day of the month) with 4 compartments (for 4x daily dosing) and the other end is marked in green. That way you can put them in the holder green-end-up when they are full and turn them red-end-up as you take your vitamins each day and the tubes are emptied. When I refill my meds this week, I think I'll make the transition to using this system.

Beating the Bushes

I think, given that today marks the 30 day count-down to surgery, that it's a good day to start beating out some of those long ingrained and ultimately unhealthy behaviors that won't help me in the future. Namely: Eating too fast and not chewing my food thoroughly. (I do chew my food, just not the way you have to chew it after surgery, when you're stomach's full of sutures and can't do it's normal digestive churning as well as usual.) In other words, it's time to make mindful eating a daily practice.

The lovely people at the Weight Center (WC) have given me a sheet containing a mindful eating exercise that I confess I have not tried, nor even finished reading through. Each time I start to read it, my eyes glaze over and my brain starts thinking of other things. I dunno what that's about, but I'm not going to fight it. I think there are other mindful eating exercises I can come up with that will do just as well. After all, the point is to slow down, pay attention, chew completely, and enjoy right? Right.

I think I'll start by reminding myself of a few salient points at the beginning of (and as often as necessary throughout) the meal.

1. I've taken the time and trouble to cook something delicious, it's foolish not to enjoy the result of my efforts.
2. Eating a meal is not a race.
3. The food will still be there when I'm ready for the next bite.
4. If other people finish their meal before me, no big deal - we're eating together to enjoy each other's company and conversation (refer to item #2).
5. My stomach does not have teeth. It cannot chew my food for me.

There! I think that's a good start. And now I'm off to brunch with my lovely wife and my friend Sally, so I'll have an opportunity to put this into immediate practice.

So Much To Do

As I have begun to wade into the fray of surgical prep, I'm realizing the vast number of minute details that need to be attended to and just...stuff that needs to get done. After 45 minutes of my brain buzzing through all this junk last night, I finally got out of bed and hauled out a Moleskine (do you know about Moleskine? I luuuuurve me some Moleskine!) and began writing a list. Getting it out of my head and onto paper definitely helped me get to sleep, but for every item I check off, there's about 3 more I add. It's getting a little ridiculous. I keep reminding myself that this can't continue forever, though, and it's just part of the ride.

Here's the list (so far):

The list isn't really prioritized, though there are definitely priorities. For starters, buying the protien supplement has to come soon because it's part of the pre-op diet I have to start on November 20th. And the power of attorney and healthcare proxy are top priorities, too, of course. I know a haircut may seem a little irrelevant, but it's been about 6 months since I've had a proper haiorcut and the ends are all dry and gross and my life will be easier if I take off about 3 inches. Eliminating hassles for after surgery seems like a good thing, all in all.

I attended the first of 2 nutrition groups for pre-op patients last Thursday. It was a lot of information I already knew - the need to stay hydrated after surgery, the required calcium and multivitamin supplements that must be purchased, etc. - but it was good to hear it all again. The nutritionist gave us each this massive binder full of tabs and not much else and told us that we will be getting materials to add to it at each subsequent nutrition group until we eventually have a binder that is a complete guide to life after gastric bypass. Pretty neat.

I'm feeling a bit less overwhelmed today as things have started to settle down in my brain. I still feel a mix of anxiety and happiness, but I don't feel like there's a pile of granite pebbles raining down on my skull anymore. Improvement! I'll take it.