Eliza55

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I am now 132 lbs, down 107 from my consult weight. 

It's been a crazy few months. I have found that I really need to watch myself when I exercise hard.  I've had two episodes where I got really out-of-it (didn't know where I was etc) after strenuous exercise.  Then 15-30 min after I eat, I'm fine.  The first time happend at the gym, I don't remember going, I came home after 5 hours (!) I lost my shoes, they had to cut open my locker, then I came home and ate two large pieces of pizza  (DH told me to stop, but I forgot I had RNY) .  Then of course, when I came to my senses, I felt really horrible from all I ate.  The second time was in NZ in the middle of the wilderness on a 4 day hiking trip.  I didn't get so far down, as a Wilderness Guide picked up on the symptoms, and made me drink ORS, and then some candy to get some sugar into my system. He said he really didn't want to have to evacuate me out of that situation.

 I really enjoyed my trip to New Zealand at 5 months out.  I was able to hike easily and able to do the Milford Track with little problem. The Track is a 33 mile, 4 day walking trip.  We did it from hut to hut, so only needed to carry about 20 lbs.  The weather was marvelous!   I did have issues with my ability to eat while in NZ.  What I could eat was very day-to-day.  Sometimes I could eat some ground beef, other days, I could only tolerate Unjury Chicken Soup flavor.  The second day of the Track I pulled my backpack tight across my hips, and after 4 hours of that, plus a little dehydration, could not eat or drink much for the next two days.  I was quite woozy at the top of the pass on day 3, even though I was drinking water, but could not really eat anything. Thanks goodness for Oral Rehydration Solution, the stuff that docs give for dehydration in many countries. Worked like a charm, and I made it down the steep and rocky downgrade, and  could drink fine by the end of day 4, which included a 13 mile walk.

I came home, retired, and spent a glorious week with DD1 skiing in Vermont.  I had a shake for breakfast, and one for lunch, and did well.  I was amazed how easy it is to go skiing when you weigh 90 lbs less.  I was hoping to spend a good deal of the winter in the mountains, but that didn't happen, as my mother got sick and then passed away 6 weeks later.  Very traumatic, and I spent about 8 weeks in AZ being with her, then planning the funeral and closing up the house.  By the end, I was so exhausted that my eating habits were horrible, and it showed.

I was able to get my 6 month labs done while I was in Arizona.  I am now working hard to get my protein level up, as I'm officially protein deficient.  It's tough when the shakes don't sit well, I'm lactose intolerant, and can't get down most beef, chicken or cooked eggs.  My old standby, shrimp, also gives me trouble, so my mainstay is fish.

I've been home for a couple of weeks, and I'm getting back on track, and started working out again.  I've caught up with most of the finances with Mom's estate, so I'm looking to the next phase of my life!

I'm now offically 3 months out and have lost 70 lbs since my consult.  70 is a nice round number.  I'm pleased with the weight loss, and I'm on target for my goal, so that's good.  I'm feeling good - getting exercise, and also working with a trainer once per week to build strength.  Arms, legs, and upper abs are doing well.  Lower abs have no strength. 

I'm still struggling with travel.  I've done a ton of it recently, and haven't found what I can eat.  I'm still lactose intolerant, and my pouch is a little finicky, so I'm still on soft foods, and I can never predict what will sit well.  Two weeks ago, I could eat two ounces of juicy hamburger.  Not this week.....  The foods that I know will do well are eggs, cheese, Lactaid milk, and non-citrus protein shakes.  I can also eat a pretzel or two, but my nut reminded me that it's a bad habit to get into, and to stop the empty carbs.  I'm working on that.  I'm starting to worry that I won't be able to eat enough during my upcoming trip to New Zealand.  I have ordered lots of Syntrax Nectars to bring with, but I'll need to eat more than that to be hiking every day.

I'm scheduled for an abdominal ultrasound next week to see if they can come up with the cause of some of my stomach pains.  I often get pains that start a half hour to an hour after eating, and they want to check it out.  Of course, since I'm traveling (again) this week, I had to postpone the ultrasound, and for the last couple of days, my pains have been very minor.

As long as I can plan ahead, I'm fine, but my worklife has been extremely crazy this past month.  I've been traveling, and working crazy hours.  I still need to find a way to get my protein and water in when I have time constraints.  In Belgium (the land of chocolate and beer) I followed the plan, but couldn't keep up the protein levels, as I was in a manufacturing location where food wasn't allowed, so we had to go to the cafeteria for meals.  So it was 1/4 c egg for breakfast, a protein shake for lunch, then 1/4 cup fish for dinner.  I lost a lot of weight, but got run down.   My food choices were really limited because of my lactose intolerance (no cheese), and I'm having a little trouble with meat etc, so I'm limited to fish for dinners at restaurants.

Because of the trip, and overall weakness from not eating for a couple of days to illness, I'm struggling to get back into the exercise routine.  It's amazing how fast I can slip into bad habits.  But I made an appointment with a personal trainer for a couple of sessions this month, so that should really help with accountability.

Weight-wise, I'm on track at 180 at 2 months.  I'm hoping to hit 173 by my 3 month check-up.

I can't believe it's been over a month since my surgery.  All is going well.

I had my 4 week check up a little early, and Dr G told that I needed to increase the intensity of my exercise, so I've been working on that.  I've been doing the ellliptical machine for about 50 min per day, 3x per week.  Today, I even did a little Wii Fit to help with my core strength.  I don't have much of that right now.

I'm still trying to figure out what to eat.  My pouch is a little less swollen now, and I can drink a lot more water.  I can finally do about 8 glasses each day.  I'm on the soft food diet, and can eat 75% reduced fat cheddar cheese, and occasionally tuna, but not much else.    It's hard for me to be patient, but I also tend to eat too fast, which doesn't help.  So I keep up with those protein shakes, and with the pureed meat and protein powder.  I'm getting in about 65 g of protein per day, which is a little lower than where I'd like to be.  I don't eat anything if it isn't protein!  

I found out I don't dump.  I had a candy bar a couple of weeks ago, and it tasted fantastic.  Oh well.  I will need to use old fashioned will power to stay away from that stuff.  I can also handle a couple of pretzels, but I'll need to be careful with those as well. 

On the disappointing side, my sleep apnea is much worse.  When I started out, my AHI with the CPAP was about 6.  After surgery, it rose to 10 or so.  I decided to wait a month to see what happened.  Now I'm at 12.5-13, which is creeping up to moderate sleep apnea with CPAP!  I called the pulmonologist's office, and brought in my sim card from the CPAP, but the office couldn't read it.  They said they'd call in a week, but that was last week, so I'll have to follow-up.

I'm in a bit of a stall - I have only lost about 2 lbs in 3 weeks.  It is frustrating, but I'm hoping it's because of the sleep apnea, and because I'm better hydrated than before.

Tomorrow will be one week post-surgery.  Time does seem to fly by, as it's been a very busy week.

The surgery went well.  Dr G was all business on the day of the surgery, and I really appreciated that.  The hospital and surgical team is all about safety - from the skin wash, to Dr G asking me to tell him what surgery I was having, to the team asking about a red splotch on my shoulder (from carrying a backpack into the hospital). The anesthesiologist had my CPAP settings, and used that as they put me out.   I had an EKG monitor on the entire time I was in the hospital, as well as a fingertip oxygen monitor.  Of course, the oxygen monitor has an alarm for pulse and oxygen.  My pulse was typically 55-60 for the first 24 hours, which meant the alarm went off the entire time.  For safety, the lowest level is set to 60, so I just went with the flow and didn't make a big deal. 

My son came with me to the hospital, and I was really touched by how great he was.  Although he is only 19, he kept his siblings up to date, and even called my admin assistant to let her know everything was OK.  He stayed through the surgery (Dr G had to wake up my son to let him know everything was OK).  My son then spent a couple of hours with me in my room.  I also got a nice visit in the evening from my daughter, who lives an hour away. 

The nursing staff was wonderful.  When I got to my room, the floor RN took a glycerin swab, and wiped lot of coagulated blood from my teeth.  My son said the brown teeth were pretty gross! (I do remember that my first request in the recovery room was to ask for a tissue so that I could spit out a lot of brown gunk from the back of my throat.)   The nurses responded to my calls in a time-appropriate fashion.  They came in right away to see what the issue was, and then prioritized it according to the requirements for all the patients they were caring for. On that first day/night, nothing ever took more than about 10 minutes. I was particularly thankful for the nurse who helped me get into the chair in the middle of the night.  My back hurt since I woke up in the recovery room.

I was amazed when Dr G said I would go home on Friday, and that I did - within 36 hours of walking into the hospital! In addition, I have had very little pain, and only 5 little tiny incisions.  Surgical technology has really come very far! 

So now I'm home, and relearning how to eat.  I did fine on the clear liquids, but I'm having trouble with moving to the protein shakes.  I think that I may have become lactose intolerant, as I had skim milk early on, and then I had horrible stomach cramps.  I can only dring the shakes at a rate of 1 or 2 small sips per 10 minutes.  So I was getting slightly dehydrated.  Today has been better, as I have alternated more concentrated shakes with clear liquids.  I can drink the clear liquids a little faster.  So we'll see how this goes for the next couple of days. 

Tomorrow is THE DAY.  I'm finally getting a little less nervous about the surgery.  Yesterday was my last day at the office, and everyone was so nice, it was really heartwarming.

I must admit that I'm really hungry and tired all the time with the liquid diet - I've been having 3 muscle milk and 3 light yoghurts every day, and I'm starved!  I've been doing this for a week, and lost another couple of pounds.  A good note to remember if I get regain is to try this for a week every now and then.  Of course, I'm craving anything carbohydrate - artisan bread, pizza etc, etc.  Nothing sweet, but a crunchy bread.  All the artificial sweetners in everything keep me from craving sweets.

I had my nuclear stress test and echo cardiogram on Monday.  A couple of notes - the treadmill goes really fast!  I could easily gone further, but I couldn't walk any faster.  I'm a slow and steady kind of person who could take more incline, but not any faster.  I passed all with flying colors - the nurse said she could tell that I had been exercising, and If I took it 6 months ago, she never would have said that!!  The doctor said everything was great, and I have no blocked arteries.  The 3-D picture of the heart that came out of the nuclear stress test was really neat.  Computers are really amazing - the technician could move the heart all aound and rotate it with a flick of the mouse.  During the echocardiogram, not only were pictures of the heart taken, but the sound of each valve was evaluated and recorded for posterity.  Of all my tests, I expected to have this one come out the worst, and it came out the best.  Thanks to my PCP who has kept me on cholesterol drugs, and nagged me to exercise all these years.

I had a little glitch at work.  The doctor said 2-4 weeks to be away from work - I figured 2 weeks without doing anything then 2 weeks at work with normal hours or working from home.  Well the disability group said 6 weeks.  My boss was shocked (and so was I!!)  I'll talk to my doc at 1 week or so, and then call the disability group.

The truth be told - I'm feeling somewhat wishy-washy about my upcoming surgery.  I always though I was pretty healthy, except for being obese.  Unlike many others on this site, for many years, I didn't let my obesity get in the way of what I wanted to do.  I hiked in the wilderness (you don't see many morbidly obese ladies over 55 out there!!!), I skied, and I am very successful at work.  This last year, I couldn't ski or hike and my health really started to deteriorate (prediabetes, cholesterol heading out of control etc), and I felt horrible, so I started to look into surgery.

As part of the pre-surgery evaluation, my surgeon has corrected vitamin deficiencies, gotten my sleep apnea diagnosed, and I've worked hard to follow the nutrionists directions on diet and exercise.  The result is that I already feel much better, and pictures of me in January look nothing like pictures of me now.   My personality profile is that I think that I should be able to do this on my own - so of course there are second thoughts about the surgery.

But in the end, I cannot do this on my own.  I was an obese child, lost weight and kept it off for 20 years but after I had 3 kids I kept adding weight, so I became a morbidly obese adult. 

I went to the cardiologist yesterday and he wants me to have a nuclear stress test and echo cardiogram prior to the surgery.  He indicated that I have risks that "shouldn't be a problem", including recurring chest pain (probably isn't anything), family history (shouldn't be a problem), high cholesterol that is controlled by meds (shouldn't be a problem), prediabetes (shouldn't be a problem), sleep apnea (shouldn't be a problem).  But when you add them all together, the result is "there might be a problem".  I'm a little nervous, but I'll be glad to hear the results of the test. 

I need to wait until I get the test pre-certified by insurance, (3-5 day process)  then try and fit in the test before my surgery date.  It is a 3-5 hour test, so it will take most of the day.  Overall, I"ll have a busy couple of weeks.  My surgery was rescheduled to August 11, one day later than the original date.  An extra day is no problem for me, as the medical paperwork is pretty crazy.  I was following up every couple of days with the pulmonologist, who was in turn following up with the sleep center, and I should get my CPAP machine on Monday, Aug 1.  I am leading an all day meeting  that day that I had scheduled with lab heads from out of town that day, but one of my managers will cover for the time that I won't be there.  Then Tues & Wed, I'm in offsites for a critical business issue, then Thurs and Fri, I'm in Washington.  Most likely, I'll have to miss some of one meeting or another for the nuclear stress test.

This past week I did better  - got lots of exercise, and ate right.  I even walked 8 miles on Sunday.  My son and I went along one of his running routes, and at the 4 mile mark, he left me to get in 4 miles of running, and I walked the remaining four miles back.  We had a good chance to spend some quality time together, so it was fun.  Of course, my arches hurt all day after that, but it was a small price to pay.  On Monday, took the day off for multiple doctor's appts, and I did another long walk (6 miles).  I switched to shoes with better arch supports for that walk.  So I walked 6 miles, and got multiple painful blisters on my feet.   Since I'm back to work Tuesday, I'll just do some strength training to give my feet some rest. 

I had my final pre-op appointment today.  No surprises.  I still need to get the CPAP machine - it's taking longer than the 2 weeks that the sleep center said to get the final results back to the pulmonologist.  I can't change that, so I won't get all bent out of shape.   I also went to the pre-surgery class that was very helpful.  The nutritionist went through all the phases of what to eat, and a nurse practioner talked about what to expect in the hospital.  Since I'm in a lot better shape than I was 4 months ago, I felt a little out of place - everyone was so much bigger than me. 

Although I've officially (dr scale) lost 22 lbs, I've lost much more in inches.  I can easily wear some of my favorite jackets that I could not button, or fit my fat arms in.  I've dropped a full pant size (to 20), and the pj's I've bought for the recovery are 1X!!!!  Quite a change from the 3x tops I bought in February, and the 24 pants I got at the same time.   So I am a lot smaller than I was, and could explain why I felt small at the meeting.  But let's not forget, I'm still more than 88 lbs overweight!  I also have the issue that in my mind, I'm smaller than I really am.

Reading through my previous blog, I noticed that I did not call the nutritionist or psychologist.  I'll definitely talk to the nutritionist at my next appt.

I came back to the blog and noted the comments about the scales - the story gets more convoluted - when I went back to the doctor, they said I had lost 16 pounds in 6 weeks - down to 223.  Just goes to show that 5 or 10 pounds isn't important - 100 pounds is important.

But  3 or 4 pounds is important - as I just hit the BMI 35 on the dot.  I don't want to stop what I'm doing, so most likely I'll drop below 35 soon.  I spoke to the insurance coordinator at the doctor's office, and she indicated that it is highly unlikely that the surgery will be coverd by insurance.  So I made the hard decision, and decided to schedule the surgery and pay for it myself.  Thank goodness that I have saved $100 from every paycheck since I was 18 for something important.

After I made that decision, I visited the pulmonologist, who told me I do have moderate sleep apnea, so I had to have another sleep study.  I was really dreading that - the first sleep study left me groggy and disoriented all the next day.  The second sleep study went better, the CPAP did take a little getting used to, but it must really work.

So I have my date - Aug 10, and I'm very nervous about it.  Not just about the surgery itself, but also my ability to lose the weight and keep it off.  My trip to Puerto Rico this past week was all about my bad habits - I was extremely stressed, didn't get any sleep, ate poorly, and didn't get any exercise, and drank lots of diet cola.  I've been getting back on track for the past couple of days, but I need to kick these habits!!!  I'm going to set up some time with the nutritionist and psycologist at my surgeons practice to see if they can help me develop some better coping skills.