horrible_monster

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Enjoyed my follow-up appointment at the Center For Weight Loss Surgery this morning. I really like my ARNP; everyone there is pretty charming, actually. And I’ve never, ever felt scolded or condescended to. I hate to use the word “empowering” because it’s kind of become a joke-word, but the attitude of the staff at the C4WLS is one reason I feel like a partner in my own care, rather than a sad, passive little science experiment or something. Anyway.

Good news: the mysterious liver lesion? Not even a thing. It’s gone. The ARNP explained that many obese patients have fatty livers; I had a fatty liver, but now I don’t. The Mystery Thing was probably just a spot that showed up on the ultrasound because it wasn’t fatty. So that’s a relief. I wasn’t seriously worried about it even when they thought the Mystery Thing was just a hemangioma; still, it’s nice to know what’s up. (As an aside, one of my favorite things about being a bariatric patient is getting my crazy hypochondria pandered to with lots of lab work and ultrasounds and that sort of thing. It’s weirdly reassuring.) (…I’ll find it reassuring right up to the point that they actually find something.)

I also got a nifty handout on poop. (“Process of Elimination: 10 Tips for Regularity.” Ha, pooping!) Because, confession time, I am all sorts of constipated. Like, I’m-going-to-slam-a-bottle-of-magnesium-citrate-tonight constipated. I guess it’s a thing? Or at least the C4WLS is hearing from enough constipated patients that they made a handout.  Things I should be doing, for sure:

• Drinking more water
• Exercising more (this is eternal)
• Eating more vegetables, probably

Maybe eventually I’ll look at incorporating Metamucil or Benefiber into my routine, but I suspect if I commit to the three points above I might return to my regularly scheduled programing, if you know what I mean. (Pooping.) I was doing pretty well there for a while but now it’s, well, it’s time. Past time. Past time for pooping.

But enough about poop.

Got weighed, of course, and I believe that for probably the first time in my adult life my BMI puts me in the “normal” category. I’ve always been at least “overweight.” Now, I have a LOT of strong feelings about using body mass index as a standard for individuals. Better writers than I (better writers than me?) have written extensively about the use and abuse of the BMI—and for the record, the health care providers I’ve encountered at the C4WLS do not cleave to a patient’s body mass index as the be-all and end-all of that person’s health, or “success” as a patient. They’ve never even given me a goal weight, though the ARNP mentioned she likes to see people get below a BMI of 30, but yeah. C4WLS prioritizes health over meeting a specific number on a chart.

What I’m saying is it’s hell of weird to suddenly find myself in the “normal” category. Especially since (A) I’ve felt well and looked pretty good for a while now, even though I’ve been in the “overweight” category for several months, so waking up one day to learn that I’m FINALLY NOOORMAAAL really drives home how arbitrary these height/weight standards can feel, and (B) I know pleeenty of women who would wilt with grief to find themselves 5’7” and 156 pounds. Plenty of women dread being in the 150s; to them, I’m still “fat.” I don’t really have a point beyond: the patriarchy/weight cycling industry/everyone has really succeeded in screwing with all our heads, and in many interesting/depressing ways. Obviously this isn’t news, but today’s “I’m FINALLY NOOORMAAAL” weirdfeels are driving it home for me.

In other, tastier news: I’ve been adding a tablespoon of unsweetened Hershey’s Special Dark baking cocoa to my Jay Robb chocolate whey protein for my daily shakes and whoa my god it’s a whole new world. The unsweetened cocoa powder cuts down on the sweety-sweet-sweetness of the Jay Robb, which is sweetened with stevia and therefore ALWAYS VERY SWEET. With the Special Dark I find myself looking forward to my two daily Jay Robb shakes. I’ve always LIKED Jay Robb whey protein, but now that I have a yummy choco-tastic way to mitigate the OMG!SWEET, well, life is better.

Speaking of consumables, I have to admit I’ve developed a bit of a weakness for the all-natural line of Quest Protein bars. I liked the regular Quest Protein bars (they’re delicious) but the artificial sweeteners gave me headaches. So I was thrilled that the “all-natural” line excluded artificial sweeteners in favor of stevia and something called luo han guo. But then I bought some peanut butter and jelly bars, which I thought were part of the "all-natural" line but aren't. Oh no, sucralose!

I should just give the pb&j bars to my husband but, knowing me, I'll probably try them and just remain attentive to whether I get my usual sucralose headache. For science. Of course, I really need to not eat too many protein bars in general; they’re supposed to be for emergencies, not daily indulgence. I’ve been good about not resorting to them for a while, but there was a week or so where I ate at least one a day (due to stress and poor menu planning) and that wasn’t the greatest. If nothing else, they’re hell of expensive, so.

ANYWAY. I’m all wound up and verbose, I guess. Better channel some of this energy into housework and job applications and, what the hell, exercise.

PS: I finally ordered my iron supplement from Bariatric Advantage. …and I think it has sucralose in it. So we shall see how that goes. I’m prepared to get in touch with the ARNP to ask if I can switch to something else, but for now I’ll give it a shot because it’s what she recommended.

• Pacific Rim: highly recommended
• Popcorn smells: more easily ignored than anticipated
• Desire for candy: tremendous, as usual. I even DESPERATELY WANTED the disgusting-sounding cereal advertised during "First Look" coming attractions. (It's some sort of crunchy grain envelope stuffed with chocolate? How could that not be terrible? And yet I if I had my way I'd be eating an entire box, right now. I am VERY EASILY MARKETED to.)
• Giant robots: yes
• Food I snuck into the theater: one ounce of organic pepper-jack (the specific movie-theater food I was craving was nachos so I thought this would help) and half a serving of cashews. Very tasty and satisfying. Didn't really miss the popcorn, but did miss the experience of acquiring a pile of TREATS and mindlessly chewing for the duration of the movie. So, uh, old habits die hard, I guess. It's weird to mourn for a behavior that inevitably made me feel awful, bloated, and sick. But there you go: junk food junkie, for real.
• Giant robots: YES
• It was a good night, even if I do feel slightly criminal for sneaking food into the theater. (My alignment is Lawful Lawful.)

Ha! Husband's gonna take me to see Pacific Rim tonight. Yes. 

Weirdly, I find myself kind of melancholy at the thought that buying some snacks is basically totally off-limits. I don't even LIKE movie theater food that much; I guess I just chafe at anything "fun" being a Thing I Can No Longer Do. Harrumph. 

Whatever; it's gonna be super awesome to go out on the town with my handsome husband and I'm going to sail through the popcorn-scented lobby with NARY A SECOND THOUGHT. 
 

Giant robots! Sea monsters! Yes!

I really ought to write about what a rotten ingrate of a bariatric fail-patient I’ve been over the last two weeks—how I cockily overestimated my ability to visually "measure" my food, leading to multiple instances of overeating that left me feeling like I was gonna daaah; how I ate all the fruit in the world; how I played fast and loose with hydration, protein and vitamins; the fact that I STILL haven’t ordered the iron supplements I need; et cetera. But I don’t want to write about that stuff right now so I’m going to go on about this morning’s ultrasound instead.

Got up early, avoided food and drink, arrived on time for my appointment at 8:30. A very friendly ultrasound tech intern took care of me, aided occasionally by her instructor. Lots of “take a big, deep breath and hold it” and “okay, breathe” and “another big, deep breath” and at one point they had me turn so my back was to them and the machine.

Nothing about the experience was particularly unpleasant but it took longer than I expected, certainly longer than the abdominal ultrasound I had in February as part of my pre-op checklist. I guess because they’re looking for something specific (my “liver lesion”) maybe they needed to take more time and get clearer images of that particular area? I don’t know how ultrasounds work.

But that’s that for now. They said my doctors should have the images within twenty-four hours so I suppose that means I’ll get an update on the might-be-a-hemangioma-thing when I go for my next follow-up at the bariatric clinic a week from today.

And now, lunch.

I’ve been so “bad” over the last few days I don’t even know what I’m going to do about me. (Yes I do; treat myself better starting now. Still, that old sense of dismay that I Ruined Everything and now there’s No Point To Even Trying lingers and is more difficult to dispel than it ought to be.)

The biggest problem is I’ve been overeating. Remember how my nurse practitioner said I should be aiming for 600-800 calories a day? I’ve been eating over 1000. (Not much over, but over.) That’s probably not great. Mostly it’s nervous eating. My husband’s parents arrive tomorrow for an eleven-day visit and I’ve been running around flailing my arms and crying because our condo has been such a mess. So yeah, nervous eating. Tonight I’m actually uncomfortably full, similar to how I used to get back before surgery when I’d zone out and eat the world and come back to reality to find my poor belly in a state of serious discomfort. I don’t like this and don’t want to do it anymore.

I’d say it’s been mostly a nervous eating thing but today it occurred to me: acid. I think I need some Prilosec. I sat still and tried to really listen to my body and on at least a few of the occasions that I’d been moaning about how hungry I was, I think I’d actually been experiencing some reflux or something. It’s been so long since I dealt with this issue that I suppose I “forgot” what it felt like. Will acquire Prilosec and see if my insane, werewolf-like “hunger” episodes abate.  

As for keeping a handle on my nervous eating, I just have to be firm with myself. And sane. I get, like, frightened when I get hungry. I seem to have picked up a state of mind that if I don’t Eat This Thing right now there will never be any more Things to Eat and I will have missed out on all the deliciousness, forever. Don’t know where that comes from; I’ve never been food-insecure or even in any real peril of becoming so. I have to remember that my new, improved, much smaller stomach is content LONG BEFORE MY BRAIN-CRAZIES ARE SATISFIED I’VE HAD ENOUGH TO EAT.

Self: calm down, eat slowly (more slowly than that), remember no one’s going to steal your damn food. And for the love of everything, exercise. I’ve been lousy about that. It’s been I-don’t-know-how-many-days since I made time for rigorous exercise. My excuse is I’ve been keeping active helping friends move, volunteering (which was six-ish hours of pretty much nonstop standing and walking), hauling loads of donations out of the condo and rearranging and cleaning things inside the condo, but still. Need to be REALLY EXERCISING FOR REAL every single day. I feel sluggish, bloated and gross. Tomorrow things will be better because I will take better care of myself.

This incoherent update brought to you by stress, dust, and the frantic rearranging of furniture. 

Just a couple notes.

I've been kind of a terrible patient over the last week or two. Not enough protein (though I'm back on the wagon) and I still haven't gotten around to ordering my iron supplement. Maybe when Mr. Horrible Monster gets paid. I've been feeling very well for the most part and, weirdly, I think that's why I've been kind of a dummy about taking all the supplements I need. Reminder to self: complacency is stupid. Onward and upward; asked the mister to pick up some more multis and vitamin A tonight. 

(I've also been sort of terrible about exercising. Why am I such a brat? This honeymoon period isn't going to last forever and I need to build up some better habits, I'll tell you what.)

And I am now, at almost exactly four months from surgery, hitting a point where my weight loss is being Remarked Upon. By the rad chick who cuts my hair, by a semi-crazy but well-intentioned neighbor lady, by one or two folks on the Facebook, et al. It's weird. When someone asks (or makes a direct comment about how much I've lost) I'll say I had weight loss surgery. But otherwise I've kept it pretty low-key. I don't know. I wouldn't be comfortable making a big public (Facebooky) THING about my bariatric surgery but I want to be honest about it, too. So I guess I've found a compromise to be only-a-little uncomfortable with: forthright if the subject comes up organically, but not drawing attention to it. 

Oh, I forgot to mention something I found interesting: apparently I’m taking too much calcium. Surprising, because of all the vitamins and supplements I’ve been on since February, calcium was the one I was definitely the worst about taking consistently. (Because Wellesse is disgusting.) Switched to Nature’s Life Super Cal-Mag when I realized swallowing big pills wasn’t a problem for me, and since then I’ve been taking one of those each day, even though the bottle says to take two. My nurse practitioner recommended cutting back by a third. How odd. It’ll be interesting to see how my calcium looks next time I get labs done. 

It’s been a while since I updated. Didn’t mean to let it go this long but things have felt so normal for the last few months that it never really occurred to me to write in the ol’ OH blog. But today was my four-month follow-up, which seems like a big deal because it’s the first time since the surgery my nurse practitioner and I have gone over the results of lab work (blood and 24-hour urine).

Overall, things are looking good for Horrible Monster. As of today I’m down to about 164 pounds, and my nurse practitioner says that’s good. (I weighed 206 the morning of surgery, on February 27.) I’m feeling well and energetic except when it comes to getting up in the morning. I’d been blaming my AM lassitude on bad unemployment habits but it looks like it probably has more to do with my exciting new vitamin deficiency.

I am deficient in vitamin A! Egad! My iron and B12 are low-normal so she told me to take relatively small amounts of OTC supplements for that. For the A, though, I’m taking a METRIC BUTT-TON of OTC supplement. It makes me a little nervous to take so much of anything but I guess it’ll be worth it if the weird fatigue dissipates. Some other things I didn’t even realize were symptoms: weird rough patches on my skin and increasingly terrible night vision. I’d figured I was just sort of a wreck, a pathetic collection of physical flaws, but it just might be the vitamin A deficiency. Interesting.

Otherwise, like I said, things are good. Once I’m up and moving around each day I’m feeling pretty great. Frustrated to be out of work (still!) but tackling some projects that have needed attention since forever. Eating is feeling normal; I’ve been eating solid foods, including meat, since the last week of April. I’ve only made one super stupid mistake (ate some delicious cinnamon bears) and regretted it IMMENSELY. Felt very sick for hours and hours afterwards. (This was only a couple days into solids and I just sort of snapped after a party and wanted some goddamn candy—NEVER AGAIN.)

I’m usually eating somewhere in the neighborhood of 800-900 calories. When I asked my nurse practitioner if I should aim for a particular number of calories she said 600-800 but not to go overboard worrying about it. I’ll probably try to walk myself back a bit, from 900 to 800. After all, I’m still in the “honeymoon” phase when weight loss is pretty easy. Better not get complacent. She also said I should limit my carbohydrates to 45 grams a day. I looked at my data for the last month in MyFitnessPal and think that 45/day won’t be difficult. I’ve certainly had days where I’ve gone over that but I’ve had plenty that were below—way more that were below, in fact.

I’m taking two protein shakes a day (Jay Robb in four ounces of plain unsweetened almond milk) and then the rest of my intake is food, actual food. GLORIOUS FOOD. I swear I appreciate food more now that I can’t just inhale a week’s supply in one gorging episode. Which isn’t to say I haven’t overeaten a few times; old habits die hard. But it’s different. And I’m wising up and serving myself smaller portions so the temptation to “just finish it so it won’t go to waste; it’s too little to justify putting it back in the refrigerator” won’t be as strong.

But yeah, everything is kind of great right now. My clothes don’t fit, except for a few I’d held onto since before I got fat in the first place—and some that I’ve stolen from my mom or received from a friend’s closet-purging mom. What I desperately need is: belts, bras (BRAS!), camisoles. And, well, everything. But those three are sort of urgent. Fortunately, between my mom and my friend’s mom (and stealing back some items I’d passed on to my sister when I got too big for them) I should be able to put together a not-too-ridiculous interview outfit. If anyone ever calls me for an interview. (Sob.)

What else? My  husband and sister and I took a series of four swing dancing lessons. So much fun. I wish we could afford to continue. When I get a job, we will. I’m insecure and anxious about dancing so I think the lessons were probably good for my soul as well as my body. Plus my husband is a natural dancer and looked really good on the dance floor, so that was a bonus. A sexy bonus.

Here’s to jobs and dance classes and delicious grass-fed beef hotdogs from the yuppie grocery store. Om nom nom.

I ATE A QUARTER-CUP OF FOOD AND I'M SO HAPPY

I CAN WEAR MY ENGAGEMENT RING I AM SO HAPPY

My surgery was one month ago. The mind reels.

Let’s see. I continue to struggle with the holy triumvirate of:

1. All my vitamins, every day
2. All the protein shakes, every day
3. All the water I need every day

Most days it feels like I can nail one or two, and fall short of the other. Frustrating, since I really don’t need to eff up my health by flailing around not doing what I need to do. Part of my difficulty, I think, is that I’m just sleeping so damn much there aren’t enough waking hours in my days to get in what I need. Sleeping in too much because I’m unemployed and my schedules all stupid, but also due to a little lack of energy. Tomorrow begins my pureed stage (THANK YOU JEEBUS) and I suspect a leeetle bit of actual food will go a long way to helping me get my energy levels up. Then I can exercise more (well, walk more—won’t be cleared for “full exercise” till my six week appointment) and fall asleep more easily so I will (fingers crossed) start waking up at grownup time. Instead of shameful o’clock, which has been my usual hour of hauling-myself-out-of-bed.

Speaking of exercise and sleep, I’m hoping I’ll fall asleep easily tonight. My father and I took a “nature walk” this afternoon that, he later calculated, meant we covered about five and a half MILES. On foot! Egad! The terrain is flat (and mostly boardwalk) so it was super easy, even deceptively easy. I was feeling it in my calves on the last stretch as we headed back to the car, but up until then we were both charging along like it wasn’t even a thing. (Frequent stops to gawp at the wildlife probably helped. I saw a turtle!) Hope I didn’t overdo it. Didn’t feel like I was pushing myself too hard at the time, but who knows. It’s 11:09 as I type this and I’m all keyed up (and trying to finish my water before bed) but I’m REALLY HOPING that five and a half mile stroll helps me conk out. It’s been so difficult to fall asleep lately. (I said that already but it’s true, and it’s distressing.)

Not much else to report. I should mention that my tastes have changed some since surgery; I don’t think I’ve mentioned that before. My About Time shakes are SO OMG SWEET ARGH ICK. It’s a shame. Sweetened with stevia, and it’s just overpowering. Don’t want to turn to artificial sweeteners, though. Those always made me feel crappy pre-op so I’d rather avoid them moving forward. Sticking with the About Time and Jay Robb (better texture than the About Time but also SO OMG SWEET ARGH ICK), but hating the sweetsy-sweet-sweet aftertaste. Thank god for Unjury’s chicken soup flavor.

(Speaking of Unjury, I’d been excited about their Chocolate Splendor powder but I noticed it’s sweetened with fructose. I’m trying to avoid fructose so I never did drink Chocolate Splendor after my surgery. My husband used up the canister I’d purchased. Tasty stuff but I need to back away from fructose.)

No idea how much I weigh, but I’m hoping I’m below 190 at this point. It’ll be interesting to weigh in on the fifteenth, which is when I’ll see the nurse practitioner for my six-week. I’m at a weird point where nearly all of my “before” clothes are obviously too large but many of the smaller items I’d either hoarded since I first sized out of them or stolen from my mother are just a LITTLE too snug to wear comfortably. Frustrating, but with a little luck (AND A LOT MORE COMPLIANCE ON MY PART) their time will come. Soon, I hope.