Saturday, November 29, 2008

Getting closer!

I only have two hurdles left until I can submit my paperwork to insurance:  

1.)  lose 7 more pounds
2.)  get my primary care to write my letter of medical necessity

November was quite the whirlwind, between the corgi Nationals, the symposium I organized and bariatric visits.  I had my psych evaluation on the 19th and I think it went well.  She told me at the end that she thought I would do quite well post operatively.  So I guess I passed!

I had a visit with my nurse practitioner this past Monday and that too went well.  She reminded me that the RNY has better results with respect to long term weight loss and improvement/resolution of diabetes.  I told her I was well aware of that, but still felt more comfortable with the band.  Unless, for some reason, it fails me, I would prefer to keep the routing of my intestines as is.  

Though I haven't been exercising in a few weeks because of my really bad viral infection (started in sinuses, worked its way down to my lungs;  just now starting to feel human again), I have no problem with adding exercise to my lifestyle.  I had been doing quite well before Nationals and when I got sick.  After going to the Nationals and seeing the other dogs, I realized Jack needs to drop a few pounds.  Like seriously.  (I knew it before, but seeing dogs at show weight clenched it)  So once we get his nails done, it's off to hit the walking trail.

Looking at the numbers, if you do the band and add exercise to your regime, I think you do just as well as RNYers who don't exercise.  And my take from reading online is that many do not.  My goal is to do agility and Rally with Jack, and I need to have some stamina to do that. I actually WANT to be more active.  So I feel comfortable with my decision to do the band. Again, I'd rather do the sleeve, but because that's not covered by insurance, the band is what I'm going to do.

So I only need between 6-7 pounds of weight loss to file with BC/BS.  I am so thrilled!  That seems like much more of a do-able number than the 27 pounds I started out with.  I was able to get the records to start with 6 pounds lower than initially, and I have LOST 14 pounds since early October.  Wow.  I don't even know how I did that.  Well, I've really cut down on snacking and waiting to eat when hungry.  And if it isn't fabulous (worth the calories), don't eat it.

Can you believe this:  I just threw away a cookie from Panera.  It was probably stale and totally not worth the calories to even see if it was stale.  I have definitely noticed a shift in my thinking when it comes to eating.  This is a good thing and hopefully will help me lose those last few pounds over the coming weeks.   The sooner they are gone, the sooner I can get scheduled!

The nurse said it usually takes 2 weeks to schedule, so she thinks I can lose the weight, get scheduled and be done by late January or early February.  I am hoping for late January, as I want to be well recovered prior to the dog shows in early March.  I want to be able to go and work (for our Nashville cluster), if not show the puppy.  

Fortunately Thanksgiving was no challenge.  I barely ate at all, certainly did not gorge. Didn't have seconds, didn't take home leftovers.  Christmas might be more challenging with all the rampant sweets, but I'll just write the number of pounds left to lose on my hand at and look at that when I reach for a cookie.  Is it worth it?  Really?

And hopefully Monday I will feel well enough to skip riding the God-forsaken shuttle busses and get back to my walking routine.  6.5 pounds--I know I can, I know I can!

Saturday, November 8, 2008


So with my pre-op plan, I have to take lots of vitamin supplements. One is sublingual vitamin B-12. It's a small, pink pill that you let melt under your tongue. It tastes like a chalky, cherry flavored baby aspirin.

Yesterday, I put my little pink pill under my tongue and was like, what gives? This one is bitter and it isn't melting. Blecch! I kept it under my tongue for a minute or so then spat it out. Maybe it was a faulty one or something.

Then, when I went to take the rest of my meds, I realized the B12 was still in my cup. Huh?

Turns out I had put my birth control pill under my tongue instead! Eeeeew, nasty! I need to pay attention about a week and a half each month as that's how long that my bc pills look similar to my vitamins!

Obviously, I need a vacation! : )

Friday, October 31, 2008

Give me this day, my daily meds

I got a call from the Bariatric clinic the other day. They had reviewed my new patient blood work and had come up with a list of vitamins I need to start. I have to take FIVE Citracal a day! Plus an extra 400 iu Vitamin D pill and the requisite sublingual B-12.

When you add all that to my regular meds for diabetes, allergies, cholesterol, GERD and my snort or inject meds, it's a lot. I graduated to the Old People sized pill sorter last year when I started on metformin. I may have to have a separate O.P. pill sorter for the calcium alone!

Funny thing was, when I was a teenager, I could not swallow pills at all. The thought made me gag. If I had a headache, I had to dissolve my aspirin in a teaspoon of water. Talk about gagging! But when I went on the pill when I was about 16, I had to learn how to swallow them. (Huh huh, learn to swallow) They were quite small and I was able to get them down. Now I have graduated to the horse pill, as I take two glucosamine/chondroitin sulfate for my joints. I might as well be swallowing eggs whole! Urrrp.

My ultimate goal is to get rid of some of those pills. My metformin. My glipizide. My simvistatin. The yippie fun injectable Byetta. The God forsaken glucosamine! The allergy stuff I'm stuck with, but I will gladly trade out a pile of vitamins for the diabetes meds any day!

Sunday, October 26, 2008

MacGyver Moment

I had a MacGyver moment a few minutes ago, though it was preceeded by an Oh Shiny Moment. Somehow, I was in the process of unloading the washing machine and the next thing I knew I was taking pictures of myself. ??? I have yet to understand my easily distracted nature. I just accept it for what it is!

Anyway, I long for the pool I lost about 15 pounds (and kept off nearly 10 of it) by doing strength training exercises in the pool and walking/swimming laps. I loved it dearly, but it became such a burden to do. I used a pool at work, which was several blocks from my office. The health center is actually moving off campus soon, so I didn't want to get in the routine only to have my world tossed into havoc later. The thing was, I ended up feeling like a pack mule, hauling all my stuff in to swim and shower and change. It took nearly two hours to exercise and shower and get ready for work. That meant two hours extra per day away from my dogs. I didn't like that.

My ultimate goal someday is to have a house out in the country. I can have a sunroom and install a swim spa. Then I can do a water workout daily with my dogs hanging out. Of course that's a jillion years away.

A great alternative for the strengthening exercises are those stretchy bands. I had a bedroom in my house I called my gym. But out of sight, out of mind. So I dragged my elliptical machine into my bedroom. Now I'm doing much better at getting on the thing, since is right next to the bed. I can get up, get dressed, hop on it and be done before I'm even fully awake. But I didn't have a spot for my exercise bands. I can't tie 'em on my elliptical because when I use them, it makes the machine move across the floors.

Finally, I figured out to take an old computer security cable mount thingy and install it on my dresser. My dresser is tres chic ala 1987 and I'm not particularly concerned about drilling 3 holes in it. I can always patch the holes with filler and touch it up, if needed. I am just happy about having a place to do my band workout (again, I'd have to damn near trip over the bands just to get out of my room) in a convenient spot.

For me, convenience is 90% of the game.

Nothing says happy like new, shiny sneakers. And dog fur everywhere.

Saturday, October 25, 2008

Reading today...

I had grandiose plans to spend today working out in the garage, getting the space organized. I even got my new sneakers in the mail yesterday (New Balance 768s, and I love 'em!). I wore them all day long, but somehow have been sucked into napping and cuddling with the dogs today for the most part. In my sneakers.

I did spend some quality time reading. A really great woman Marilyn at online support group, suggested reading It Ain't Over Till The Thin Lady Sings, by Michelle Ritchie. Being an Amazon junkie, I got it. I also got WLS for Dummies and a few post-op cookbooks. It's going to be hard enough after the surgery. I don't want to get there and then be miserable in the puree and soft food phases by not having come up with an eating game plan in advance. Yes, most people say your tastes change after surgery so what you like before (especially with respect to protein powders) you may hate after. Still, at least the action of researching helps keep me focused and on track.

Anyway, I am grateful to Marilyn for the reading recommendation. The book is a great reminder that surgery is simply that: surgery. They don't tinker in your skull while you're under. Issues and problems you have prior to surgery will not change with it. You still have to do the hard part yourself. I know that, but it's good to have a little manual that reminds you of it. She also has a lot of good mental exercises to go through. I'm just reading first, then will go back and do the exercises later.

I do have some food triggers, so I simply don't bring certain things into the house, like chips and dip. But another one of my triggers is my beloved purple chair. It sits in the middle of my living room, sending out a subliminal siren song to come nest in it's cozy embrace and to relax in front of the tv. Come snuggle with meeeeee! I'm pretty sure I'm going to have to stab it with a knife! Okay, maybe not that, but I may have to replace it with a rocking chair. I was with Katy last night at dinner at Cracker Barrel and had great fun sitting outside rocking for nearly an hour. Rocking like a crazy person is definitely a good quad workout! Feel the burn!

The trigger

I remember my enough is enough trigger. I was at Carra's and we were looking at the Alice x AT puppies, who were living in her bedroom. As usual, I had my camera in tow as I love to document things with pictures. Yeah, old age makes you forget things fast, ha ha, so I'm always taking pictures. Never a model, always the photographer.

Anyway, I was sitting on her bed and I caught a glimpse of myself in the mirror mounted on the wall by her closet. Yikes. A small head poking from a massive torso. I always look worse sitting down because my legs push up all the belly fat.

I was mortified. You look like that, seriously? Seriously? I usually see myself at home, standing up in front of my own bathroom mirror. I didn't think I looked that bad. It was like seeing myself for the first time, in that mirror on the east side of town.

That was what propelled me to the doctor's office and got the bandwagon rolling. It was painful, but I'm glad that mirror was there.

Here's one of the puppies, for entertainment value (because she is SO cute!)

Tuesday, October 21, 2008

The journey begins

Now I don't even remember what the trigger was to get me going. Something just clicked and enough was enough. I went to a surgical weight loss seminar back in the spring. I half heartedly piddled with the paperwork after the fact, but didn't really make any progress. In late September, I just had enough with being obese and sick and called to make an appointment with a surgeon.

I had my first appointment with Dr. Williams on October 3rd and things have been moving quickly. I wasn't supposed to see a doctor until November, but a cancellation happened and I got in a month earlier. While at the clinic, I got a check list of everything I need to do in order to submit my paperwork to the insurance company for approval. I am lucky--my list is relatively short:

  • Lose 10% of my weight. It's an insurance thing to prove your dedication. Fortunately they use your highest documented weight from the past 2 years. So when you factor that in, I only have to lose 10 more pounds, since I had lost about 15 pounds last year when I did physical therapy
  • Psych consult. Gotta make sure I'm not a total froot loop and am doing this for the right reasons. I think I am. I just need assistance. I have too much to lose to do it completely on my own. Plus I do better when I have a lot of support from the doctor's office. That's scheduled for late November.
  • Letter of medical necessity. My primary care has to write this and it shouldn't be a problem. He also has to provide medical records to prove I've been fat more than 5 years. Yeah, ask my knees. They'll tell ya!
  • Meet with a dietician. There are 3 required visits: a group class, a one on one consultation and a pre op consultation. I've done the group and have the one-on-one scheduled for early November.
  • Go to support groups. Two required, though one plus active participation on a weight loss website will suffice. Check those off my list.
There are tons of medical clearances (cardiology, pulmonology, sleep studies, GI studies, etc.), but based on my previous medical testing and records, I got out of them. Yippee!

Since I made the decision to do this (still waffling on the exact type of surgery), I have felt this odd sense of calm. Though my eating is far from perfect at this point, I am paying more attention to what goes in the old hatch. And I have significantly upped my exercise in order to get those 10 pounds off. I'm doing lots of walking and for the last week, I've gotten up and done 20 minutes on the old elliptical trainer. The pre-op pounds are starting to come off and that makes me happy.

I have also started doing some test runs. After surgery, you have to go through phases of sustenance, like clear liquids, full liquids, pureed food, soft solids and regular food. And protein, protein, protein! Apparently post-op, you have to do a lot of protein powder drinks. So I'm researching them now, trying to find ones that are not grainy or disgusting. I'd rather have my ducks in a row now, than have to figure this out later.

So the journey has begun. I'm looking forward to seeing where it takes me.