whyweight88

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After a long while, I'm back to writing. Hello to anyone who has clicked through to me and stays to read. I'm Jessica and right now I am three years (October 22, 2009) post-op.

So many amazing things have happened because of my surgery. I met new friends, traveled to exciting places, and fell in love with the man of my dreams.

Growing up heavy resulted in a tenuous self image that I still struggle to nurture to this day. Even after the triumph of being able to shop where I'd like and take part in activities without the embarrassment of being the biggest person present, I still have so much to learn about truly harnessing what it means to live as healthily as possible after surgery.

I intend to keep recounting my thoughts here, and to share my feelings about how my journey to a healthy body is still very much a work in progress.

To be continued!

J.

A little update. :)

In the last few days, I've actually (according to Wii Fit) gained about half a pound back. The BMI is teetering upwards by mere decimal points. This happened to me a few weeks back, but only once. I subsequently dropped 15 pounds. I don't know what's up. I've looked back on what I've been eating, and the food is getting a bit richer; I don't do just cheese and crackers anymore. I recently turned to salads with plenty of chicken or tuna and have been using a light sesame ginger dressing or just regular ranch. If it's really the ranch's fault, that would be awful. I don't get in much more fat a day than a couple of tablespoons of salad dressing, so the culprit still eludes me.

My portion sizes have changed. They're larger. I am no where near as bottomless as I was before surgery, but it has to be noted that at 3 months out, I've wondered if I have stretched my pouch prematurely. Paired with the inexplicable weight gain (not even a pound yet, but I'm terrified of the Wii Fit board now), my spirits are down despite the progress I've made so far.

My 3 month check-up was last week; the doctor told me I am ahead of schedule and the percentage of weight loss I'm experiencing is higher than typical results (me = 38%, typical = somewhere around 25-30%?). I just smile happily and nod, but I have no idea what that really means. I leave the office wondering if those figures are given to make me feel better.

In any case... the way it feels to have nearly 60 pounds off of me is--to say the least--relieving. To be honest, although it's a bit of a shame, I still don't like looking in the mirror and am all too acutely aware of the 95 pounds that still remain to be lost. It's been too easy in the last few days to really resent myself over the fact that I had become so big... And still am.

I'd like to write more about what's happening in my life, but I'm finding it hard to sit still for too long. I might update my photo album later with more comparisons. No full body shots, unfortunately. Maybe when I'm braver.

For now, here's a... time lapse type of deal:

http://i45.tinypic.com/2s93qfl.png

I'm recovering without any difficulty. I have lost 24 pounds (the first 20 were within the first week). I think I'll remember the first three days as the toughest; I was very sore and tired (of course), so having to walk around so soon was a big challenge. I was able to stop taking Lortab four days post-op and the soreness from my wounds gradually faded away.

Right now, I'm having a little bit of trouble deciding and organizing what to eat every day. I'm disappointed with the brand of protein shake I bought and have been avoiding it, using other foods and drinks to get in my daily goal. I'm looking into a couple of cook-books made for WLS patients and paying attention to the forums to see what others are eating.

I'm looking forward to whatever's coming up next.

Been a while!

The behavioral modification class wasn't an enlightening experience or anything. It was worth the reinforcement, I guess. I don't have much to say about it. As for the endoscopy, it was a really weird experience! Anesthesia is scary stuff. RNY will be my first surgery and my third time undergoing anesthesia; my first time was for my wisdom teeth back in 2007.

I don't remember anything after they stuck some tubes up my nose. All in all, it didn't take up as much of my day as I thought it would and they let me know that everything looked fine.

That was back on August 6th, by the way. Haha. I've been really lazy and haven't updated as regularly as I meant to from the beginning.

So I waited until last week to be contacted with a surgery date!
October 22, 2009!

I'm relieved to finally have the surgery 'in sight', so to speak. I've been to the Vitamin Shoppe across from the hospital. The employees were spoken to by Dr. Lord, and I got to take home a sample of the Nectar protein supplement and a grocery list for WLS patients. They were really nice, and I am stoked about the FREE rewards program they have. It's a pretty decent system, and I expect that I'll be returning to purchase my supplements, so I'm happy about that.


For anyone who is local, please get in touch with me if you're interested in starting an independent support group. I have yet to go to a support group on the 1st Tuesday (I meant to go this time around but I forgot!), but I want to be able to attend these and hopefully make some local friends who I can get together with a few times a month.

I posted an ad on the Pensacola Craigslist, so if you want to read more about it, please check this out!
http://pensacola.craigslist.org/grp/1356189781.html

I really look forward to my new life and want all the support I can get!

As part of my surgeon's pre-op education program, I've been required to attend two classes (nutrition orientation, which has already been covered, and a behavioral modification class, due 7/2). In the past week, I have seen both the nutritionist and psychologist on an individual basis.

I am continually impressed by the staff; I keep my expectations low when it comes to 'customer service', but I can say with confidence that when I am there for my appointments, I feel relaxed and then empowered on my way home. They are making my big decision very easy to put hope and faith into.

With the psychologist, I discussed my background and situation while growing up--quite a typical story. She was keen on my work schedule, which truthfully is out of the ordinary. I am an independent contractor specializing in art and design. I also offer copy writing and branding services. All of these things I do from wherever I please, able to connect with clients on an international scale. Since I have such an open schedule, I was able to take every appointment on the first available opening, enabling me to zip right through towards a surgery date. Explaining this was fun and exciting. I think she was intrigued.

We went on to my history of dieting and exercising, which as anyone could guess has been one failure after another. She sent me home with a very profound (at least to me) subject to contemplate; obesity is a physiological problem, not psychological. I have always thought the other way around. According to her, diets are money-hustling traps that cause people to work hard towards an inevitable failure. Supposing that a person has achieved their goals with satisfaction, as soon as the specific diet is deterred from or stopped, the body responds to this 'freedom' in a way that often reverses the entire effort. She emphasized the 'starvation' mode that the body enters into when diets (which involve restrictions of any kind, including calorie intake, low carb, low fat, etc) are implemented; the body will fight against this endeavor for every pound it can keep because it is inherently designed to recognize when a person's eating habits have changed.

She was quite to the point and left no real room for me (in the interest of time I'm sure) to really think it through aloud, but I understand that many diets are designed with bonafide interest in teaching a person to eat and live healthily. Obviously, calorie restriction and closely monitoring sugar and fat intake are the most important things. It is when a diet involves supplements and/or pills that then qualify it as a 'program' that sets people up for failure. Unless the person is comfortable with spending on these expensive products for the rest of their lives, as soon as they stop, the body begins to work as it only knows; it uses what it needs and stores what it doesn't. We can assume that a diet program's supplements make it easier to manage hunger or block certain things from absorbed or stored. Applying the psychologist's conclusion that diets do not and never will work seems logical. Our willpower can and will faulter (as it's only human); the way your body works is more or less out of your hands (no pun intended, ha).

This is how I analyzed her point. I feel that because her case is very convincing, that I am simply programmed by society's insistence on living 'thinly' before even considering simply living 'healthily'. The diets are always focused on empowering the mind before the body; the response to success is supposed to motivate you--but what about your body? Is it really working as triumphantly as you feel? No, you are the one with feelings. Your body is always the same; when you are feeling free to eat and do as you please, there are those times when excess is simply inevitable. There--that was her arugment--that what drives you can only do so much. You cannot train your body, only your mind.

So, do I want to rely on being rigid for the rest of my life? Fearing failure again, resulting in spending more money on supplements or restricting myself from variety? It exhausts me just thinking about it. It is impossible. I am too eager to live life without that burden.

I can't say I am still on the fence about this one; I am more convinced than ever now that I've written it down. The goal--my goal--after having this surgery, is to give my body a chance to work a little differently. Instead of fearing that an entire buttery roll will shove me right off the wagon if I break down and go for it, I would rather learn to recognize that the roll is too much anyway. I want to be able to look at something, healthy or not, and know exactly how much I am allowed. It is a mind-body synch that I am seeking through RNY--a way to achieve success and maintaining it because it will become 'natural' for my body to communicate effectively that the hunger is gone, so all that may be left is head hunger. By channeling head hunger towards other things--living an adventurous, active life for example--health and being thin are simply things that fall into place. I won't have to force it there and live in fear of losing it anymore.

I received a report in the mail yesterday, which is a two and a half page summary of what we talked about, how she feels about it, and why she thinks I am able to make an informed consent to surgery. I was never nervous about the potential to 'fail' this evaluation, but she wrote it in such a way that made me feel even stronger about my determination.

The nutrition evaluation was more or less a repeat of the orientation, which was conducted in a group setting. The fluid and protein intake cited in my literature (a binder full of research, paperwork, and information from the clinic) was adjusted to meet my needs (calculated from height). After that, it was a general review along with a cordial introduction. I got to know a little bit about her and she was able to give me advice and guidance according to what she learned about me.

There was a short quiz near the end of the appointment that I passed without any wrong answers. We reviewed each question. This is a 'forever' change; the repetition is a little tiring, but I understand and appreciate why it is required. I learn new things every day through internet research--I am very lucky and grateful to have a nutritionist here locally to go to with questions or concerns about this surgery. I feel that my time and money (I payed $500 for the program, and the insurance is taking care of the rest) is being spent to its fullest potential.

I will be starting the lab work next week, beginning with having my blood drawn. There are some X-rays and an upper endoscopy that I will have to get out of the way before I see the surgeon again to determine when to schedule the surgery date.

I am very confident that I have made the right decision for myself. I am becoming eager to mark the surgery date on my calendar.

This was a two hour session with the nutritionist who works with bariatric patients. I was included in a small group (5 or 6) of people. Along with the binder of information I received at the initial appointment, I now have a packet of very specific information on eating as a person who has had gastric bypass surgery. I'm sure a lot of people would agree that the fact that you have to change your habits overnight isn't fabulous or even fathomable. The before and after pictures are so enticing and most of the time all you hear are great things--but to sit with the nutritionist and be given realistic, visual evidence of what life will be like the day after and for the rest of your life... I can understand being overwhelmed.

As for me, I was expecting the class to reiterate all that I have researched and conditioned myself for. Many things were still new, however. The order in which the supplements and vitamins are taken, and especially the specific doses were things I really had to hone in on. I now fully understand the reasons for such dramatic weight loss during the first year or so. As gastric bypass patients, we are allowed only so much food or drink (and never, ever food and drink)--for a lifetime. That the pouch eventually expands to be able to withstand about 4 cups is promising.

I have always had reasonable doubts about how well I will do with so much deprivation so quickly. The list of foods that are allowed are absolute (under my bariatric surgeon's care, anyway), and I'm afraid growing up with a 24/7 steamed white rice cooker is going to make for some really tough mental battles. I'm just looking at it this way; it all began with all those delicious starches and carbohydrates--I can end it any time, with or without the surgery. I chose the surgery because I wanted true and constant control over my eating habits. I want to actually maintain successful weight loss. I'm no longer ashamed to admit that there is something about who I am that prevents me from falling back down from great heights like physical fitness. I don't consider this surgery a sign of weakness. I consider not trying something different weakness.

Well, here's hoping.

I was surprised when things went smoothly; the only hiccup was a misunderstanding about an unusual insurance track record that I've been dealing with this year. I am currently under Tricare Prime, the umbrella that I've had over me as a military dependent all of my life. When I turned 21 in February and was no longer a full-time college student, I lost the coverage. After paying for a quarter of CHCBP (Humana Military's Continued Health Care Benefits Program), I was covered for three months before I was reinstated as a special circumstance after submitting some paperwork pertaining to my personal situation. After explaining this to the nurse who handles insurance issues (in so many words), I was taken straight through my first visit with swiftness.

It was the usual after being called back. Height (5'8"), weight (284 pounds--yowch), blood pressure, and temperature. After that, I was shown to a room where I would wait to meet with the surgeon for a short one-on-one about my physiological eligibility and overall decision to have this surgery. I have chosen the Roux-en-Y Gastric Bypass method. I had my 'before' photo taken, was lightly examined, and explained to about my surgeon's experience and credentials. I'd known as much from the seminar I attended in February of this year; he spoke, as well as much of the team I subsequently met yesterday at the initial appointment. I feel as though I am in good hands. I trust Dr. Lord and was reassured by the staff; two of the women I met had undergone this particular surgery and look stunningly different from their hospital ID tags.

My insurance policy pays 100% of the hospital and sugery fees. I was responsible for a non-refundable $500 program fee (which includes the pre-op education materials and consultations), which I payed reluctantly but have awoken the day after feeling no regret for. Here is a breakdown of the materials I was given immediately and what is required of me before scheduling an actual surgery date:

Educational Materials:

- Three-ring hard-cover binder with divided sections for easy references for patients to read through. Eligibility, insurance/fees, surgical methods, diet and nutrition, and other resources are included. I am assuming that since I must carry this program book with me to all of the consultations (I'm even subject to a $25 replacement charge if I lose it), the literature will be referred to.

Tests:

- Chest X-ray
- EKG
- Upper Endoscopy (for which the x-ray and EKG are pre-requisites)
- Blood drawn and tested for a variety of different things
- Ultrasound

Consultations (what the $500 program fee is for):

- Nutrition orientation (1 hr)
- Psychological evaluation (1.5 hrs)
- Behavior Modification (2 hrs)

I require no supervised diet nor a letter of necessity. Once I have cleared all my consultations and the testing is finished and deemed acceptable by Dr. Lord, I will be ready for a surgery date.




The Sacred Heart Institute for Surgical Weight Loss is a clean, quiet office staffed with friendly and knowledgeable personnel. They speak realistically about the risks of morbid obesity itself, those of not having the surgery, and of course, the risks of having the surgery. I was speaking to nurses who have had the surgery and are living post-op lifestyles. They look great and speak very highly of Dr. Lord's Bariatric program.

So far, I have met with these people twice--once at the informational seminar and again at the appointment yesterday; they know what they are doing, as is appropriate for a Center of Excellence. I have spent more than half a year preparing myself for my final decision and feel confident about beginning this journey.

I'll be writing again as I go along...