1 Year and 2 Months After Surgery

Sorry it has been so long since my last post. As it so often happens, life gets busy and time really flies fast!


It is now just past a year since my surgery on May 12th, 2016 and I have lost a total of 181 pounds! At first the pounds really shed away like hair off of a cat in summer. It has slowed now to about 5 pounds a month. Which is fine with me as long as I am still losing weight. I also don’t exercise every day (maybe only once a week at the most) so I would lose weight faster if I did it more often. I also still have my occasional junk food like mac and cheese, chips and fries. Don’t get me wrong, I also eat salad regularly as well as fruit, dairy, meat and occasional vegetables (admittedly, vegetables are my least favorite food group). I just eat a lot less of the bad foods. Like when I eat mac and cheese, just one of those little microwave cups of mac and cheese is perfect for a meal. Right now I am eating a bagel with some cream cheese (which I only do about twice a week). I usually just eat half of the bagel, but sometimes I can eat the whole bagel if space it out over an hour. My apologies to all the vegetarians and vegans out there, but I have been craving meat daily since the surgery. I crave it every day. I feel like such a carnivore! I usually eat chicken and sometimes my favorite – beef. I bake chicken wings (not fried) in the oven and they are delicious! For beef I usually do meatballs or beef fajita strips heated up with various seasonings. Protein is very important in my diet and something that all of my doctors insisted that I make sure that I get enough of after the surgery. No problem there!


Now here is the key to eating after a gastric bypass – eat slowly. ALWAYS eat slowly. It takes 7 minutes for food to reach your stomach. With a smaller stomach, it doesn’t take long before it is full so if you eat quickly, your stomach will be full before all of the food has reached it. I am sure you can imagine what happens when your stomach is full and more food tries to enter it. Not a pretty picture. You also have to be careful with drinking liquids when eating. Liquid will fill up your stomach very quickly. Doctors suggest drinking before you eat, then again after you are done eating and no longer full. What I usually do is drink before eating and take little sips of water during my meal. I do mean a sip. Just enough to help wash down the food and wet my mouth.


Healthwise, my blood pressure has been around 140/90 for months now. I feel fine. I am still not taking any blood pressure medicine (I had to take it for 20 years before I had the surgery) and so far none of my doctors are concerned – just as long as it doesn’t go any higher. My cholesterol did go back up to what it was before the surgery, but lately it has been going back down. It is common when losing a lot of weight fast for your vitals to go crazy. Up, down and sideways lol. Up until recently, I had still been taking the full amount of cholesterol medicine that I have been taking for years. However, a few months ago, my primary care physician decided that my cholesterol was doing well enough to try cutting my cholesterol medicine in half. So for five months now, I have been taking half the dosage of my cholesterol medicine. Next month when I see my doctor again, I will find out how my cholesterol is doing on the half dosage.


Before surgery, I weighed 419 pounds and my kidneys were having problems. They were operating at 55% and my blood was highly acidic. I started to see a Nephrologist. She put me on Sodium Bicarbonate pills and I have been seeing her since my surgery. I was also instructed to drink more water and eat more vegetables. Slowly as time went by, my kidneys got better. Each time I went back, they were better and better and the acidity levels in my blood were getting lower. I recently visited my Nephrologist earlier this month and my kidneys are now at 95% capacity. Unfortunately, my blood acid levels are up again. So she put me on a higher strength Sodium Bicarbonate and told me once again that I need to eat more vegetables. Sigh…my downfall – veggies. So I am trying to find a way to incorporate more vegetables into my diet since I am not a fan. I do like corn and cauliflower, so I am adding those to my diet. It’s a start. I have been eating a salad with lettuce, tomatoes and cucumbers about 3 times a week – but I need to eat vegetables every day.


Other than that, I have been doing great! I have more energy and can get so much more done in the day. Lol the only downside to having more energy is trying to sleep. I have asked my primary care physician to prescribe me a light sleeping pill to help me sleep at night. Without it, I wouldn’t fall asleep until the sun came up. But now I can fall asleep soon after taking the pill. Only problem is that most nights I only get 6 to 7 hours of sleep before I am wide awake again. I am such a light sleeper – always have been. So I wake up every time one of my dogs bark or I have to turn over. Hoping this will change someday. Oh I forgot to mention that I no longer use the CPAP machine as I no longer have sleep apnea! I may not be able to sleep past 7 hours most nights, but the quality of sleep is very good. It is so nice to no longer have to sleep with the CPAP machine! One of the things that the sleep study experts do is measure your neck. They said that the thicker the neck, the more likelihood of having sleep apnea. After measuring my neck, the nurse said mine was now a normal size and that I could try sleeping without the CPAP machine to see how I did. I have been CPAP free for 6 months now and feel refreshed in the morning (depending on how many hours of sleep I get – 7 hours of sleep and I feel really good).

Here is a “before and after” photo of me. Before surgery and 1 year after surgery. Yes I did edit out a person just for privacy reasons. ūüôā
In the second photo, I am relaxed – no I am not sucking in my tummy as so many people do in their “after” photos. I wanted an accurate photo for my weight loss journey.

So just past 1 year out and doing great other than a few hiccups. I am sure those wrinkles will also be ironed out in time. Though I am starting to get the skin folds that so many people get after losing a great amount of weight. The fat goes away but the skin (when stretched out as far as it does when weighing 419 pounds) does not shrink back very far. I suspect that one day I may have to do another surgery to get rid of the extra skin, but I will cross that bridge when I get to it. I figure I won’t worry about that until after I reach my goal weight of 150 pounds. I currently weigh 238 pounds – so only 88 more pounds to go! I might even go past my goal weight….we shall see. Gosh…only 88 more pounds. That is such a great feeling!

Two weeks after surgery

[EDIT]
I started this post two weeks after my surgery, but never finished it. Finally got around to finishing this post! ūüėÄ

I had an appointment with my bariatric doctor two weeks after the surgery – my first time driving since the surgery. I actually did fine. I would have prefered if it was cooler as it was since it was late May in Texas. But at least it was overcast – so the sun was hidden and that helped. My bariatric doctor looked at my incisions. I told him that the scab fell off on two of them so I used band-aids to keep them clean.
bandaid
He told me that the band-aids were keeping them too moist and to take the band-aids off so that I could form new scabs. He was right – one day after taking the band-aids off, scabs were forming. Now one month after my surgery, my incisions are still healing, but the three smallest ones are completely healed. I still have three more to heal.



dizzy emote
I also told them I had been dizzy since the surgery. They took my blood pressure and it was 88/54 – that is why I was so dizzy all the time. Blood pressure is supposed to be 120/80. I was told to stop taking my blood pressure medication. My blood pressure was too low and I didn’t need the medication for now – just keep checking my blood pressure daily to make sure it doesn’t get too high or low. After not taking my blood pressure for three weeks now, it is at 126/64. That is a good reading.

I had to go to my main doctor for a bladder infection recently. She took my blood pressure and it was 130/84. It was 144/90 when I first walked in. I was hot from being in my car and outside. That drives up my blood pressure. Just waiting 15 minutes in the air conditioning and it went down to that 130/84 reading. I told my doctor that I usually had been getting around 120/70 at home (124/64 was my last reading). She confirmed what my bariatric doctor had told me. Stay off the blood pressure medication and monitor my blood pressure daily. She said I just might be done with having to take blood pressure medication. HappyChild_view from abovesm
My next appointment is in August, so we will do blood work then and see if I still need my cholesterol medication. My cholesterol levels were really good last blood work (which was before my surgery) so my doctor said that I probably won’t need any medication for my cholesterol at that point.

Splashing water from glass
First three days my diet consisted of nothing but clear liquids. Talk about giving you diarrhea! Sorry if this is TMI. So I have had water, clear broth (beef and chicken), Jello (it melts in your mouth to liquid) and a few other items that were listed in my diet book from the nutritionist. I was so glad to get past that stage! Only so many times you can drink the same clear liquids over and over. So for the next two weeks, I moved to all liquids (adding opaque liquids). That includes soup with no chunks in it – such as tomato soup, split pea soup and yogurt (smooth with no fruit). Once I visited my bariatric doctor at the two week mark, he looked over my tests and said I was good to move onto the third stage in the bariatric post-surgery diet – soft foods. I could finally have food with some substance to it!

Surgery Day – May 12th

Sorry it has been awhile since my last post. It took some time before I felt up to writing again.

I once heard from someone that had this same surgery that they had to go 24 hours without drinking or eating anything before their surgery. But for me, they just told me not to eat or drink anything after midnight. Easy enough to do.

I had to be at the hospital at 7:30am. So 5:45am I started my shower with the special antiseptic soap that the hospital gave me during my pre-op visit. I followed the directions included with the soap. It took ages to wipe my whole body down, wipe it all down again, wait two minutes, then rinse myself off. I was now sterile lol.
Bathing

I went to the hospital for my 7:30am appointment and after waiting in the lobby for about 5 minutes, I was led to a hospital room. My boyfriend came with me for support and he is the one who drove me to the hospital. Once I got to a room, the first thing they had me do was undress down to what I was born with and put on a large and roomy (thank goodness) hospital gown. I also got the free pair of non-skid socks in my least favorite color – yellow. Then I had to wait and wait. There was a TV in the room, so I watched an episode of a sitcom and half of another show.

Finally they had room on the pre-op floor. Here is where the real fun began. Remember my horrible veins that didn’t do well with having an IV put in them? Well….this was still true. I am glad I had the support of my boyfriend to hold me while they tried repeatedly to put an IV in. I told them I was a “hard stick” with needles, so the lady used a sonic machine that showed where all my veins were. It was like one of those overhead projectors that teachers used to use in school. It shone a green light straight down onto my arm and you could see dark ribbons in the green and those were the veins. So she found a fairly good vein and tried it. The vein burst. She told me I have brittle veins. I was told not to worry about the burst vein – my veins are so small and collapse so easily that they close quickly and all I would have there is a bruise. She tried it again in my hand. The machine showed another fairly good vein and the lady tried putting an IV in with the same results – the vein broke. This lady felt bad for me and told me that they would try another machine that showed veins deeper than just the surface. By the way, this is a stock image – my veins are nowhere near that large. My veins are like tiny threads.
Green vein finder

In about 10 minutes, another woman came in with an ultrasound vein finder. She tried the same arm but another location with the vein breaking once more. So she switched arms. After two more times of veins either collapsing or breaking she finally got a good (well good enough) vein that will work for an IV. Whew! After what felt like an hour of poking and sticking even with the aid of two different machines – I finally had an IV in me. I pray I never need to have surgery again!
ultrasound vein finder2

So after the tears had dried and another hour had passed, they said they were ready for me in the operating room. I was wheeled down the hall, to an elevator and down some more halls. I do have to say that it is so fun being wheeled around on a hospital gurney! I had this same thought when I had my upper endoscopy several months back. It reminds me of sledding as a kid lol.

When I got to the surgery room, my first thought was, “Wow it’s cold in here” and my second thought was, “Oh my goodness it’s just like in the movies!” lol. Obviously I have never had surgery and never been in a surgery room before. They brought the gurney I was on right alongside the operating table and had me scoot over onto the table. They had a bunch of towels wadded up down along my spine and I heard one nurse tell the doctor that she put the towels to raise my belly up. It was dreadfully uncomfortable. But I didn’t have to worry about it long. They kept telling me to breathe – I don’t know if I was shallow breathing or what – but they kept telling me “Breathe”. What was funny to me was it wasn’t a quiet and relaxed voice saying “Breathe” like how you would imagine someone would say if you were going to be hypnotized or relaxing at a spa. No they were shouting it at me. “BREATHE!” I couldn’t say anything as I had a mask over my nose and mouth. But I was thinking “I am dammit!!! Geez!” I think I was awake for only a few minutes and 4 times of hearing them shout “BREATHE” at me before I fell asleep. It’s actually funny to me now that I think back on it. I was the last surgery of the day so they might have been anxious for me to fall asleep lol.
Operating Room

I slowly and groggily woke up in a dimly lit room. It must have been the post-op room because there were beds along each wall. The nurse was talking to me but I had no idea what she was saying. My wonderful boyfriend was at my side sitting in a chair. ūüôā It was very nice waking up with him there. I then fell back asleep. When I woke up again, I was in my own private room. I was less groggy now. I had previously told my boyfriend that he could go as soon as I got my own room on surgery day. So I was alone now. But that was ok. I was in my own room that had a window and TV. A nurse came in to make sure I was alright and checked my vitals. They checked my vitals once every few hours. I had an IV drip and I found about every 4 hours I needed another dose of pain medication. All I had to do was buzz the nurse and they came in to give me more pain meds. I knew it was about every 4 hours because there was a large dry erase board on the wall opposite my bed that had my vitals written on it and when my pain medicine was last administered. I noticed in the crook of my arm was a little green camo teddy bear with a t-shirt that had the logo of my bariatric doctor (“Live by Losing” was the name). Isn’t he cute?
LBL Bear
I watched some TV and relaxed as best as I could. I was very thirsty but wasn’t allowed to drink anything until they did an X-Ray with some nasty tasting liquid to make sure I didn’t have any leaks. I had a catheter in now, so I didn’t have to go to the bathroom – that was nice. I didn’t even feel the catheter so I didn’t know I had one until they took it out.

My medication made me sleepy so I spent most of my time sleeping then waking up to a nurse checking vitals. I brought my CPAP machine so I pretty much kept my CPAP mask on the whole first day. I did have a lot of bloating and pain from the air that they had to blow into my tummy area to get it to billow up so they could see what they were doing during the surgery. They only made 5 little incisions for the surgery and used tools that were in straws that can be inserted into the small incisions. There was no clock in the room so I had no idea what time it was. But that was ok – I slept a lot and could at least tell if it was day or night from the window. As it was getting to be dusk, they decided it was time to take out my catheter and take me to be X-rayed to check for leaks. Once again, I was wheeled on the gurney to another floor. They put me in a room where there were other gurneys along a wall, all separated by curtains. After waiting about 5 mins, they had me stand up and walk over to the X-ray machine which was in a room about 100 feet in front of me. I slowly walked over and they told me where to stand. After getting into place, they gave me the foul tasting liquid. I didn’t mind the taste so much – it was the first thing I had to drink since before midnight the night before surgery. They told me everything looked fine – no leaks! I laid back on the gurney and waited for my ride back to my room. Back in my room, they gave me a tiny cup of water to sip on. Oh it was wonderful! Now by cup, I mean one of the tiny cups they usually give people pills in.
hospital cup
Maybe another hour or two went by and they brought in three more little cups. One had water, one had chicken broth and one had some cherry jello. It was just a swallow of each, but after surgery, I was to only sip everything and that is all I wanted to do. Take it easy and sip.

Sometime shortly after dark, when the nurse came in to check vitals, I asked if they could help me up so I could try the bathroom. I had not used a bathroom since the previous day because of the catheter. I made it over to the bathroom and was able to go a little bit. After I finished up, the nurse helped me back to my bed. She asked if I was able to urinate and I said I did go some. She said that was very good as it lets them know that everything is working right. Later that night, I was visited by another nurse – a male nurse this time. He told me that I needed to get up and walk around. I really didn’t want to – but then he told me that the more I walked around, the more the pressure from the air in my abdomen will go away. I was all for getting rid of pain and pressure. So he helped me out of bed and I hung onto him with one arm and my IV stand with the other. We walked halfway down the hallway and he asked how I was doing. If I felt well enough we could walk all the way down the hall, or we could just go down the side hallway where we were at and make a circle. I opted for making the circle around back towards my room. I walked the loop and got back to my bed. The nurse said I did really good. The next morning he had me walk again. This was after several times of getting up to go to the bathroom throughout the night. He mentioned that I was walking faster and I was only holding onto the IV stand. It was easier to walk this time and I felt better.

After another “meal” of the little cups of water, broth and jello and several hours of watching TV and many more vitals checked, it was now about mid-day the next day. They told me I could go home and said I could call my ride to come pick me up. I told them I didn’t bring my phone for security reasons. My boyfriend’s phone was listed as an emergency contact so they had his phone number and gave him a call to come pick me up. I wasn’t even finished getting dressed yet and my boyfriend was already there. The staff brought a wheelchair when I was ready and I sat down in it. I was wheeled out to the car and carefully got in. An uneventful drive home and I was greeted by my two dogs who missed me terribly the last 2 days. I had to fend them off as they were jumping up on me. I walked to my bed and made a nice little nest with pillows and watched TV. My boyfriend brought me a sugar-free popsicle and water. Ah it was nice! My two dogs laid down on the bed beside me and we all relaxed while I watched TV. I was sent home with a “pain ball” for the pain. It was a small black cloth bag with a shoulder strap. In the bag was a plastic bag with a liquid in it. There was a small tube leading from the bag to an incision in my upper abdomen. I was told that in a couple of days the liquid would run out and I could take the tube out. Sure enough, two days later, the brown liquid stopped flowing in the tube and the tube was clear with only drops of the liquid remaining. I opened the black bag and saw the plastic bag was mostly empty. Time to remove the tube from my abdomen. I am very squeamish…..so I had to build myself up to pulling a tube out of my body. After staring at it for a bit, I started pulling….and pulling and pulling. I pulled about a foot or two of tubing out. Oh I nearly fainted. I was so grossed out! I quickly took everything and threw it away. I suppose I could have kept the black cloth bag, but I was so grossed out that I just threw it all in the trash. I put a band-aid over the hole. I also got a prescription of a composite pain medicine that needed to be compounded at a special pharmacy. My boyfriend picked it up when it was ready. I took it about every 6 hours the first few days, and after a week, I only needed it to sleep. The prescription only lasted two weeks, but by then I didn’t need it anymore. They also gave me a prescription of a vitamin supplement that included Cyanocobalamin, Folic Acid, B-12, B-6, and vitamin D which I am still taking along with all my other vitamins.

Last Bariatric Visit Before Surgery

I had my last bariatric doctor visit before the surgery. It was two weeks before the surgery.

First was the weigh in. I am back down to 394! Bye-bye Easter candy!
They discussed with me what to expect the day of the surgery and what to do the day before and morning of the surgery. I was given two items. The first item was a clear plastic package with two individually wrapped bottles and hand “towels” (a terry-cloth mitten). A two minute timer (an hourglass with sand) and instructions were also included. Inside the bottles were an antiseptic/antibacterial soap called Dyna-Hex CHG (chlorhexidine gluconate) solution. One bottle and towel was marked “Morning” and one was marked “Evening”. As expected, the “Evening” package is for use the night before the surgery. The “Morning” package is for the morning of the surgery. Both are to be used in the shower. After washing my hair, I need to use the solution to wash my entire body from the neck down and leave it on for 2 minutes (hence the timer). After the timer is up, rinse off. Same for the morning of the surgery. These are to help prevent any infections after the surgery. The antibacterial solution is going to kill most of the bacteria on your body including the staph bacteria which 1 in 3 people carry on their body at all times. This bacteria is normally harmless unless it gets infected in an open wound. This is why they made the CHG solution – to kill most if not all of the bacteria on the skin before surgery to greatly lessen the possibility of getting a infection.

The other item that was handed to me was a plain white cardboard box. Inside were two leg cuffs to be placed on the calves after surgery. They are used to help prevent blood clots in the lower legs. I was told that I could wear these for up to 10 days after the surgery, depending on how often I walk. Apparently, if I walk daily, then only a few days. I will ask the nurse after the surgery how long for sure. The leg cuffs have velcro to wrap around the leg and have an air tube leading out from them. There was also an air pump/battery pack that came with a cord to plug into the wall. The cuffs provide alternating pressure on the legs to keep the blood flowing.

butterfly-needles-description
After my appointment, they had to do some bloodwork and get a urine sample for some final tests to check for any infections and check my vitamin levels. As usual, I tell the lady that will be drawing the blood that she will need the smallest possible butterfly needle made. Even with the butterfly needle, the lady trying to draw the blood could not find a vein after poking around for awhile and gave up. Using a cotton swab and tape, she covered the spot where she stuck me with the needle. I was sent upstairs to the lab to have a professional phlebotomist draw the blood and have me “pee in a cup”.

I went upstairs and waited to be called back. Well this lady phlebotomist knew her stuff. She got it with one stick and I was done in only a few minutes. She was a large lady like me. After drawing the blood, she turned around to enter all my information into the computer. She knew I was there for my last doctor visit before weight-loss surgery and we were discussing how much my life will change. I told her, “You know, it’s amazing all of the things that skinny people take for granted.” She stopped typing and turned around, eyes wide. She spoke slowly and told me, “Say that again…” and looked into my eyes. I repeated myself and she said, “Girl don’t you know it!!!” We then mentioned different things that skinny people might take for granted: like being able to sit in a movie theater or an airplane, sitting in a booth in a restaraunt, being able to use a seatbelt in a car without a seatbelt extension, being able to use a regular bathroom stall, buying clothing in a store instead of having to buy all your clothes online at one or two special “Plus Sized” stores and being able to fit in an office chair at work (I know this one very well – most work places don’t have large enough computer chairs so either I have to sit in a tiny chair that is crushing my legs or buy one and bring it in).

red-blood-cells-modified
My bloodwork results did come back showing that my white blood cell count was a bit high. I told them that it was because I have psoriasis and it often creates a high white blood cell count as it is an autoimmune disease (over-active immune system). I also told them that another doctor back in mid-March (less than 2 months ago) also found my white blood cell count a bit high and ordered chest X-Rays to make sure I didn’t have pneumonia or some infection in my lungs. Those X-Rays came back clear. My bariatric doctor wanted to see those blood test results and X-Ray so I had my other doctor send them over. I got a call a couple of days later from my bariatric doctor’s office telling me that they got the tests from the other doctor but still needed an updated X-Ray as “normal procedure”. I was mad at this as I am already getting about one medical bill a day in the mail and doing yet another chest X-Ray just seemed so redundant and stupid. But my hands were tied. If I didn’t get the second X-Ray, then they wouldn’t perform the surgery. Plus I had to do it the day that I was going out of town – so I left straight from the imaging place to my destination. The next week I called my bariatric doctor and asked if they got the new X-Rays back yet. She said they did and that they were clear. Imagine that. So I asked if I was still cleared for surgery, and she said that I was. Onward!

Doctors, Doctors and more Doctors

3-doctors2

So in addition to seeing a nutritionist and doing a sleep study, I also had to see several other doctors to make sure that I was mentally and physically prepared for gastric bypass surgery.

Let me say this about weight-loss surgery. When I originally decided to have weight-loss surgery, I only saw the cost of the surgery. My insurance will cover a great amount of it, so I could afford it. But I didn’t know about all the other costs that would be added to that cost of the surgery such as the high co-pay every time I had to visit the bariatric doctor (which was many times in the six months leading up to the surgery) and of course the anesthesiologist will be a separate bill. There is also the cost of all of the specialists you have to see. Plus, if they find anything wrong (such as me having sleep apnea), there are additional visits and possible new equipment to purchase. It isn’t a scam, it is just something I was unaware of. I just want everyone who chooses to have weight-loss surgery to be aware of all the extra costs involved. Thankfully, everyone is willing to take payments and my insurance covers about three fourths of the bills. Just be prepared for the extra costs.



The open hands of woman. Your objects here
One specialist I had to see was a psychologist. They wanted to make sure that I was in the right frame of mind for going through surgery and wasn’t “crazy” or had depression problems. I had to fill out a 10 page questionnaire at the office before seeing the psychologist. Questions like “do you hear voices”, “how often do you find yourself depressed”, “do you eat when you are depressed”, “do you binge eat”, and “do you ever feel fearful”. After filling out the paperwork, the psychologist reviewed my answers and asked questions relating to my answers. At the end of the session, the psychologist smiled at me and said, “Well, you can tell everyone you are not crazy,” then said that I am clear for surgery. Before parting, the psychologist told me, “you are a really fun and upbeat gal!”. lol that was probably because I do laugh a lot and am a very positive person.



Digital visualization of a human heart
Another specialist on the list was a cardiologist. My bariatric doctor wanted to make sure that my heart was strong enough for surgery and for the exercise that I will need to be doing after the surgery to aid in weight-loss. If you don’t exercise after surgery, the quick weight-loss will make your skin flabby and depending on how much weight you have to lose, the excess skin will have to be surgically removed as it can be a health hazard. The more you exercise, the tighter your skin will be. Since I am around 400 pounds, the cardiologist didn’t have me run on the treadmill like most people. They gave me a heart monitor with a total of 4 wires attached to my chest and side. I had to wear it for 24-hours and bring it back the next day. Every time I did any strenuous activity, I was to push a button on the monitor and it made a time stamp. I then had to write the time and activity into a log. The next day I gave the monitor back to the cardiologist. While they were reviewing the results, they ran an EKG* on my heart. After waiting in the patient room for a bit, I was told everything came out good and I was cleared for surgery. One more hurdle leaped.



Doctor chasing patient with shot
The most dreaded thing that I had to do before the surgery was an upper endoscopy. I had to be admitted into the hospital and have an I.V. put in. The I.V. was the worst part. I have very tiny itty-bitty microscopic veins. I had one person on each arm and hand feeling for a good vein and poking and probing as they went. After many pokes, one girl was probing around with a needle in the back of my hand and it hurt so bad that tears started streaming down my face. I begged her to please stop. She then said she would get the numbing spray to use on my hand. I thought, “NOW you want to use the numbing spray????” She did find a vein eventually. In a half hour or so, I was wheeled into the “operating” room. They then put me under and snaked a camera down into my stomach to have a look around. They had to check for any lesions, ulcers, tumors, etc. With a gastric bypass, they don’t remove the stomach – they keep it to help aid in digestion. I woke up in my room and they told me that everything looked fine other than my stomach lining looked a little irritated. Once again, I was approved for surgery. Whew! Glad that one was over with! However…I think I now fear getting the I.V. for the surgery more than the actual surgery.

*“Electrocardiography (ECG or EKG*) is the process of recording the electrical activity of the heart over a period of time using electrodes placed on the skin. These electrodes detect the tiny electrical changes on the skin that arise from the heart muscle depolarizing during each heartbeat. It is a very commonly performed cardiology test.” ~Wikipedia

You are what you eat.

If you eat healthy, you make your body healthier and feel better. When you eat trash, you trash your body and feel sluggish.

healthy_food_VS_Junk_Food

One thing my insurance required me to do to qualify for the surgery was to visit a nutritionist once a month for six months. This is to get you into the mindset of eating healthier and get on the path to eating right. The nutritionist also prepares you for your dietary needs after the gastric bypass. I learned so much from just those six visits. I also got a handbook from the nutritionist breaking down what food is allowed after the surgery and during which time period (right after the surgery, two weeks after, six weeks after, etc.).

Just from what I learned during those nutritionist visits, I went from my starting weight of 419 pounds to 394 pounds in six months. This showed my insurance company and my bariatric doctor that I am motivated to lose weight and a great candidate for the surgery as I will be more likely to stick with the program and diet even after the surgery. One thing they mention when you join the program: “If you gain weight while in the program prior to the surgery, there is a chance you will be kicked from the program”. I wasn’t perfect….I fell off the wagon a few times and gained weight. The important thing is, I got back on the wagon and was able to lose the weight again. I know I won’t be able to do that forever. In the past, I eventually stayed off the wagon after every diet. That is why it is important that I still get the surgery – even after showing that I can lose weight by sticking to the program. In the end, I weigh less than when I first joined the program and that is what they look at.

I weighed myself every month at the nutritionist’s office so I used the same scale every time. Here is how my weight loss went:
419 – Starting weight in November when I had my first nutritionist visit.
412 – Early December visit.
412 – January visit ~ this is what happens when you spend Christmas with your family and eat all the family meals over the holidays. But at least I maintained my weight.
402 – February visit ~ back on track!
394 – March visit ~ under 400 pounds! Yay!
399 – Early April visit and last nutritionist visit ~ Easter happened….I admit I am a chocoholic. My parents came to visit and brought some Easter chocolate with them. I thought I could handle it and just eat a little at a time. Nope….
394 – April 28th ~ Had an appointment with my bariatric doctor – yes it was a different scale, but should only be off by a pound or two. Either way, it shows I am back on track again!

The biggest improvement to my diet and the very first thing that I did was cut out soda completely. That was so hard to do. I was a soda hound. I used to drink 4 of the 16oz bottles of Dr. Pepper every day. For me, quitting soda felt like what it must be to quit smoking. If I smelled it, I wanted it. Certain foods that I always ate with soda made me crave it so bad. In fact, all meals tasted a bit different without soda. I craved it all the time! Even now, 7 months after my last soda, I still crave them to some extent. I can still remember what they taste like and I miss it. I used to drink diet soda, but still gained weight. After I heard about how bad Aspartame is, I switched to regular soda. I still gained weight. But either way – soda is very bad for your body. All the sugar, chemicals, carbonation, acid and caffeine are destructive to your good health. I am very glad I don’t drink soda anymore. With all of that caffeine, my moods were always up and down all day. Now I am “steady as she goes” as the nautical term says. It was so hard to quit soda that it made it easier for me to not go back and drink one. I remember how hard it was to quit and don’t want to have to go through it again.

Another thing that I cut out that I admit I occasionally fall off the wagon with is fast food. Did you know that you can make a taco or hamburger at home and have it be only a fraction of the calories that it would be at a fast food restaurant? I asked my nutritionist why this was, and she said it was the quality of ingredients. By using the leanest beef you can get, light versions of sauces, etc. – you can eat similar food to what a fast food chain would carry but at only a meager portion of the calories. Well, at least I eat fast food a LOT less than I used to – and it shows in my weight. I used to stop by a fast food restaurant for a meal at least 3 times a week. Now, I only do it once every two to three weeks. After the surgery, I know I will have to stop eating fast food all together as the grease and fat will make me very ill. Sure I could still get a salad at many fast food joints, but I make a far better salad at home.

The third item that is cut out of the diet is fried food. Nothing that is cooked in oil or deep fat fried. That cut out my favorite fast food restaurant – Long John Silver’s. I adore their shrimp. I used to get a very large portion of their shrimp every Friday as part of my weekly routine. They got to know me by the sound of my voice at the drive-through speaker and we would chat for a while at the window. Good sign that you might be eating unhealthy if you are on a first name basis with the staff at a fast food restaurant. I even said goodbye to them at my last visit there. It was the week before my first nutritionist visit. I told them I would miss them and they said to just stop by anytime and say hi – don’t even have to order – just say hi and catch up. I guess part of this is also because I live in the South and people tend to be more friendly here. I never have gone back – I don’t want to tempt fate…or challenge my will-power.

In going to the nutritionist, I learned to eat healthier. Not just less, but healthy and balanced meals. I was instructed to keep a log of what I ate, when I ate it, how much I ate, how many calories it was and how much protein a day I consumed. Protein is very important for someone having weight-loss surgery – it is needed to help with the healing after the surgery. They stress the need for protein constantly. Whether it be lean meat, low-fat cheese, nuts, eggs, or protein drinks – the requirement is 60-80 grams of protein per day. I was told not to go over 80 if possible because too much protein per day every day will make your kidneys over-work and possibly fail. After the surgery they stress liquids first (so no dehydration), protein second, produce third (fruits and vegetables) and all else is last (grains, etc.) – depending on how much room you have in your stomach.

I was trained to eat small portions of every food group. My nutritionist suggested something like a bento box for meals (a segmented box with a lid). I got 5 and on Sunday would make all my lunches for the week. I took a photo of my bento boxes after I filled them and showed it to my nutritionist. She said it was perfect! Lots of variation in food (something she had been drilling into me) and each of the food groups. Here is the photo:

BentoBoxes

Looks pretty good, huh? That is tuna fish, by the way, in the bottom right section. I liked putting it on the Ritz crackers. Of course, as my nutritionist told me, Ritz crackers were not the best choice in crackers as they are buttery and have more calories than other options such as Wheat Thins. I got Wheat Thins as well – I like both crackers. I am not a big vegetable person, but I like cauliflower and carrots, so I stuck with them for lunches. I love tomatoes, so grape tomatoes were easy for me to eat. Blueberries are also a favorite of mine – and something my nutritionist encouraged me to eat as they have very few calories. Yet, sometimes I had strawberries or raspberries instead of blueberries. I would also often switch out the vegetable and meat choices for variety. For dinners, I would have a chef salad which would have all my veggies and protein in one meal. Sometimes I would cook some chicken wings (baked not fried) or have some artichokes that I would dip into fat-free calorie-free Parkay Spray butter. Guilt-free butter – gotta love it! I have even made homemade hamburgers with lean meat or tacos which provide lots of protein and veggies.

I also learned that there are four stages of diet after the surgery.
Stage 1
First two to three days after surgery – nothing but clear liquids. This includes hot broth, ice if you want to chew on something, flavored water (I hate those), caffeine-free herbal tea (no milk and no sugar – bleck), sugar-free sports drinks, clear protein drinks (GNC has become my best friend for protein drinks!), sugar-free popsicles (yay!) and sugar-free Jello (yes not a liquid but if you dissolve it in your mouth until it is a liquid, not a problem). I can still take my medicine and vitamins, but must crush them with a pill crusher and dissolve into water.

Stage 2
For two weeks after stage 1 – everything in stage 1 including any opaque liquids. Still nothing with lumps or anything that could get stuck in the stitches of your stomach which would cause complications. So this includes skim milk, decaffeinated tea and coffee with skim milk, low-fat yogurt with no fruit included and cream soups such as tomato soup (again nothing with any solid chunks in them). I am sure there are other things as well that are opaque liquids, but these are some of the items listed in the handbook.

Stage 3
For two to six weeks after stage 2 – everything in the previous stages but also soft foods. Sugar free pudding, soft low-fat cheese, low-fat cottage cheese, all soup, eggs, canned chicken or canned tuna (soft and moist – they say to avoid dry meat or poultry at this point), 90% or more lean ground beef (boy will I be looking forward to this one – I adore beef!), canned fruit in unsweetened liquid, unsweetened applesauce, bananas, hot cereal such as oatmeal and Cream of Wheat and mashed potatoes (with only with light butter or margarine on top). I am pretty sure watermelon would be included in this list – one of my favorites! Again, there are more than listed, just soft and moist foods.

Stage 4
Last stage – this will be the regular bariatric diet. Everything from the previous stages including all fruit, any lean beef/chicken/fish, all vegetables, whole grain bread/pasta/rice/cereal/crackers, potatoes (no this doesn’t include french fries lol), low-fat dressing and just eating healthy and sensibly. NO fried foods, NO sweets and everything has to be low-fat.

All stages require 60-80 grams of protein per day and you must sip every liquid – no gulping. Also food must be chewed thoroughly before swallowing. You must drink your liquids 30 mins before and 30 minutes after each meal so that your tiny stomach doesn’t get filled with water when it should be meal time and getting protein, vegetables, fruit, etc.

Fruits and vegetables on rustic background

Where to start? Sleep study!

First thing I had to do was find a bariatric doctor that was covered by my insurance. I found two of them nearby and researched each doctor online. I looked at reviews and thoroughly scoured their websites. One of the two doctors stood out by far with¬†lots of¬†awards and positive reviews. I called their office and made an appointment.¬†It has been confirmed many times over the last six months since I made that appointment that I made the right choice. Everyone in the medical field that I have talked to asked me who was going to do my surgery. After I tell them, the response was always the same: “Oh yes, he is a great surgeon! He is the best bariatric surgeon¬†in the area!”

This is me before starting the program.

March 17 2015

 

It did cost $250 to join their program. See they don’t just do the surgery and shove you out the door. They want to make sure that you succeed. They want to make darn sure you are ready for the surgery and not going to have¬†the surgery and then have “buyer’s remorse”. It is a big decision and if you are not sure you want to do it, you will have time to change your mind – but this helps weed out the people that are not serious. A gastric bypass is a life-time commitment. It will change the way you eat for the rest of your life. No going back.

I started the program October 21, 2015. Since then, I have had many appointments with the bariatric doctor to see how I am doing on the program and for weigh-ins.

Ok – let me explain how the program works. After the initial appointment and weigh-in with the bariatric doctor, they have you do bloodwork to see where your vitamins are at and if any are low, you are requested to take vitamin supplements to correct the deficiency. I found I was low in Vitamin D (imagine that – as I have alabaster skin and burn in 5 mins under the sun). I had an ultrasound done on my legs to make sure there were¬†no blood clots in them (none were found – phew!). An ultrasound was also done on my gallbladder to make sure I didn’t have any gallstones. They check for stones because they can remove the gallbladder at the same time as the weight-loss surgery since they will be working in that area anyway. Turns out I do have gallstones. They asked if I wanted to wait for any pain to show up before having it removed or just remove the gallbladder at the same time as the surgery. I thought to myself, “wait for pain?” and told them to just remove it at the same time.

I was then handed a list of specialists that I will need to see. I was told these doctors will call me to set up an appointment. There were six doctors in all. First one was a sleep study. They had to find out if I had sleep apnea. What is sleep apnea? Here is an explanation I found on Yahoo Answers:

“Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times.
There are two types of sleep apnea:
Obstructive sleep apnea (OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
Central sleep apnea: Unlike OSA, the airway is not blocked but the brain fails to signal the muscles to breathe due to instability in the respiratory control center. ”

Not getting enough sleep (a good and proper sleep) will mess up your metabolism and hinder weight-loss. Not to mention sleep apnea will make you tired, cranky, sometimes have headaches and wake up in the morning feeling more tired than when you went to bed. I had some of those symptoms so I suspected that I did have sleep apnea. What is a sleep study like? This cartoon captures it perfectly.

image002

Turns out I did have obstructive sleep apnea. Usually, the first half of the night they determine if you have sleep apnea. The second part of the night (if you are positive for sleep apnea) they try you out on a CPAP (Continuous Positive Airway Pressure) machine that blows air through a face mask and helps keep your breathing passages open. In reality, since I am such a light sleeper, I had to do the test in two appointments. It took me four hours just to fall asleep. Then I had to buzz the attendant a few hours later when I had to go to the bathroom and they had to help unplug me from the machine so I could walk down the hall. I still had all of the sensors attached, just the wires were unplugged from the machine so I had to carry the wires with me and throw them over my shoulder to “tinkle” in the bathroom. I got back to my room, the attendant plugged me back in and I lay there trying to fall asleep again. I think I slept for a couple of hours before I was awoken by the attendant¬†who turned on the light and told¬†me that it was 5:00am and the study¬†was over. I was told that I slept just long enough to determine whether or not I had sleep apnea. They would call me to see if I needed to return for another sleep study to try out a CPAP machine (after it was confirmed by a doctor if¬†I did indeed have sleep apnea). I went home and went to bed.

A¬†few days after the first sleep study, they called me and told me that I did test positive for sleep apnea and needed to make an appointment to come back in and do another sleep study but this time with a¬†CPAP machine to make sure that it would cure the sleep apnea. Again with the millions of wires….but this time I also had a mask strapped to my face and the strange sensation of air being forced into my lungs. As with before, I slept just enough for them to determine their results. I was told that the CPAP machine worked in curing my sleep apnea. They also said that I should feel so much better after finally sleeping without the apnea interrupting my sleep. Yeah…sure maybe if I was a heavy sleeper. I felt like telling them, “Let’s strap a million wires to your body and a large mask to your face in a strange bed and see how well you sleep!”

Looks comfortable, eh?

patient_cpap_frustrated

The attendant said that I still had the whole day to go out and get things done because I should feel so much better! I went home and went to bed.

About a week after the second sleep study, I got a call from a Home Medical Equipment company to make an appointment to get a CPAP machine and get fitted for a CPAP mask. “Fun…” I think, “I am already a light sleeper, so sleeping with a mask strapped to my head with a hose leading from it is so totally going to help me sleep better”. After the fitting and getting trained on the proper use of¬†a CPAP machine, I went home with doubt in my heart that I will ever be able to sleep properly again. That first night it was like wrestling an octopus….and the second night….third night…..second week…..third week…..eventually I would just sleep out of pure exhaustion. It was more of a passing out than falling asleep. After a month they asked me how it was going with the CPAP machine. I told them “not very well” and asked how long it takes for someone to get used to the machine and mask. The reply was, “Oh, it is different for everyone. Some people get used to it in only a week. Most get used to it in the first month. But some people have been known to take 3 months to get used to the CPAP.” Great….

I did stick¬†with it and used it absolutely every night. You know what? I did eventually get used to it – three months later. But now I am glad that I have it. I do wake up more rested even if I do still have to wrestle with the air hose every time I turn over. I have occasionally taken a nap without the CPAP machine and I notice a huge difference. I don’t get any rest when sleeping without the machine. So in the end, it worked out.

About three¬†months after getting the equipment, I went in for a follow-up. Instead of a sleep study, this time I brought my CPAP machine in and they downloaded the info from the machine to see how well the sleep apnea had been cleared up. I was told it worked perfectly and that I no longer¬†stop breathing¬†during sleep while on the CPAP machine. That is good. I told them that I was also finally getting used to the machine and did sleep a lot better. I will have to return in a year just to make sure that the CPAP is still doing it’s job. But other than that, I was done with this leg of my weight-loss journey.

 

So why a gastric bypass?

“Why so drastic?” you might ask.

Let me give you a little background.

Up until the age of 21, I was thin as a rail. I ate what I wanted, never exercised and never gained a pound. It was great! Then almost overnight, my metabolism changed. I had several body changes and started gaining weight. I ate the same things as before and was just as active. I had my thyroid and everything else checked and it was all normal. But the pounds started adding to my body. Every year I gained more and more weight. I tried several diets in my life. I even tried just eating 1 meal a day. (I later found out that only eating 1 meal a day stops your metabolism so you¬†don’t burn any calories). Dieting and exercise worked for a little time. I would lose a few pounds, but as the old adage goes – I gained it all back again and then some. The weight gain got worse and worse. At my heaviest weight I was¬†419 pounds. I have seen that show “My 600 Pound Life” and that truly scared me. I did NOT want that to be me!

I found out that my insurance covers a great percentage of weight-loss surgery. But I have never had surgery and it scares me to death. I hate hospitals – the smell, shots, pain, etc. I am allergic to pain (lol). So I did wait a few months before I decided it was time. Time to take control of my life. I am tired of not fitting in chairs with arms, having to buy clothes online because the stores don’t carry my size (not to mention the high cost of clothing in my size), tired not being able to stand for very long without my back, feet and legs hurting and not being able to walk very far before I am out of breath. Don’t even get me started on stairs. Time to regain my life – I want it back. I haven’t been thin since I was 21 – that was 25 years ago. I can’t even remember what it was like to be thin.

There are also my health issues to consider. I have high blood pressure, high cholesterol and am pre-diabetic. My lower legs painfully swell to the size of balloons every day that I don’t wear tight knee high socks.

I looked at the options for weight-loss surgery: lap-band, sleeve and gastric bypass.

The lap-band requires you have a port in your side so they can reach the band – ewww. Plus I had a co-worker who had a lap-band that slipped. She fell violently ill and had to have a rush surgery to have it removed. No thank you.

The sleeve seemed like a good solution that wasn’t so drastic. They staple your stomach so that it is just a tube (sleeve) and cut away the excess stomach. It makes your stomach smaller so you don’t eat as much. I have heard that some people have regained weight back when getting weight-loss surgery. The sleeve had a higher chance of this happening because it was easy to just stretch out the stomach again. I figured it probably was¬†a low percentage of¬†people that gained the weight back, so I thought I might do the sleeve. My mind¬†changed when I visited my general practitioner (family doctor) a few weeks later. The woman who checked me in said she heard I was going to get weight-loss surgery and thought it was great because she had the sleeve done many years ago. I looked at her in surprise because she looked like she was maybe 250 pounds. I said, “Really?” with astonishment. She understood my surprise and explained that she was losing so much¬†weight so fast that it scared her so¬†she stopped the special diet and gained all of the weight back. I saw it was too easy to “fall of the wagon” with the sleeve. This was the problem I had with all the diets I tried in the past.

In the end, I decided the gastric bypass, although the most drastic choice, was the one for me. My mom had a gastric bypass and she swears by it. She looks great and feels great. Apparently the bypass is the surgery that loses the most weight. With my 419 pounds, I have a lot of weight to lose. The gastric bypass will apparently make you ill if you eat sweets, greasy food or other bad foods. It forces you to eat healthy and in smaller amounts. That is what I need as I can have willpower on my own for awhile, but not for a very long time.

So here begins my journey.