Monday, November 9, 2009

My First ER Visit, EVER!

The ability to swallow my own saliva was a short lived ability.

I got up Sunday feeling okay, but tired and weak and a smidge dizzy. My poor brain was jonesing for some Lexapro. Well, maybe I could take one after some warm beverage. I nearly got stuck taking one Saturday before the trip to the vet's office. So I wasn't looking forward to it.

Because I hadn't had much of anything in days and I was down 10 pounds since Wednesday afternoon's weigh in, I thought I would do hot cocoa again. Yeah. Not a good idea. Two small sips was enough to wake the Slime Monster.

This attack started about 9:15. By 11:30 I was still sliming and it showed no signs of stopping. I was anxious, jittery and worried. Enough was enough. I had to go to the hospital.

Here's a word to the wise: make sure you have an emergency contact number for off-hours for your surgical clinic. I assumed I had one, but I didn't. I emailed my nutritionist, Jessica, and my surgeon, but wasn't sure if they checked work email on the weekends. Lord knows I don't! I tried calling the hospital but got nowhere, there. I asked the guy who answered the phone if I came in, could they page the on call surgeon? "Ma'am, that's hearsay. If you need to come in, come in."

WTF? Hearsay? I asked you a question dude, I didn't tell you a rumor. I just want to know if the ER can get me my doc!

I gave up and decided to go in, spit cup in hand.

The time to go to the ER is 11:45 on Sunday. I was called back in less than a minute and in a room within 5. I curled up on the gurney and the emotional relief of being seen by medical staff helped me calm down and the sliming finally stopped. I slept for a few hours while they were paging the on-call doc, periodically interrupted by ER docs.

I had to laugh--one of them compared me to Goldilocks. This fill's too loose. This fill's too tight! My bandy is not very easy going. Very picky. Not enough, not enough, not enough--OVER THE TOP!

I'd say why me, but hell, why not me? Nothing in life has been smooth sailing, so why should this be an exception? I believe things happen for a reason. Obviously there's some lesson I'm supposed to be learning. I just have to figure it out. And make the most of it. Shit happens, and I'm not immune. I can either whine, or I can learn.

I was giddy to be awoken by Dr. Foster! Have I mentioned yet how much I adore her? She reminds me of the pediatrician Arizona on Grey's Anatomy. Like when Arizona gets in there with her patients and relates to them (last week where she had the kid with the bowel problem go on rounds with her and practice his algebra by calculating meds). So I was excited when she came in and 100% confident she'd take good care of me.

Dr. Sexton helped her out and he was great, too. Whew. I was terrified they were gonna just send me some ER doc who knew nothing about Lap Band ports that would make things worse. But my great team came to the rescue.

Unfortunately, though fortunately for my ER bill, they were not able to get me to a fluoroscopy suite. So they numbed me up with some lidocane and went on the hunt for my port.

I'm the Atypical Bandster for many reasons. One of which is my challenging port. Twisted 20-odd degrees (in spite of being anchored to my abdominal wall on a piece of surgical grade screen door fabric!) and covered in scar tissue. It's not easy to access for an experienced surgeon with visual access (x-ray). But Dr. Foster did a great job of getting in there blindly. It took awhile and involved sit-ups on my part. But she did it.

She pulled off the 1.5 ml she added earlier in the week and I felt immediate relief. They brought me a cup of ice with a dash of water and the first sip went down perfectly. Ahhhh, the best water on earth! I was able to drink 1/4 cup over a few minutes with no adverse effects. That was the most fluid I'd had in awhile! Glorious! Then I had a cup of apple juice! JOY!

While I drank, we chatted and she said she was hoping this wouldn't happen! Me too! But at least it was fixed. And she's amazing. The normal protocol after a problem like this is a complete unfill. But she only took off that 1.5 ml because she knew how frustrating my band has been. It took 7 months and 6 fills to get me just overshot. The first 6 months, NO restriction.

I told her I had a trip coming up to Chicago and a hectic week at work prior to that. So to be on the safe side, she took off another 0.5 ml before removing the needle. So I was up 1.5 ml and now I'm down 2. Which is okay. I can drink fluids again!

Long story short, the bandster existence is not always straightforward. For a vast majority of patients, they have surgery and a few fills and viola! They're at restriction and life is good with the steady pound or so a week weight loss.

Then there are the complicated people like me. It can be very frustrating at times. But I am losing and at least the docs are learning how to deal with challenging ports. And I had a really nice 2 hour nap, too. No barking dogs or anything!

Like I always say, it could be worse. Of course try asking me that after I get the bill. I'm sure I won't be so chipper then!

Attack of the Slime Monster

I'm breaking my story up into pieces so it's not tooooo overwhelming in length. : )

Saturday morning I had lots to do. I was able to slowly sip a mug of coffee and after that, had a 6 oz yogurt. Wooo hoo, things were looking up!

I loaded the dogs up and we went to the vet for Jack's shots and for Dr. B to take a look at Map's limp. Lucky us, she has luxating patellas. Probably a grade 2. Whew. Not bad enough to require surgery, but enough to give her some arthritis at the ripe old age of 3. Her prescription is Flexamin and aspirin.

On the way back, since I had had such good luck with the cream of broccoli soup at Panera (8oz = 190 calories, 10g fat, 16g carbs, 8g protein) on Friday, I decided to get a big bucket of it to eat off of for a few days.

Needless to say, my luck ran out. Apparently, I was still a smidge swollen from the Yam Incident and after a few scant teaspoons, I felt the unmistakable clunk of getting stuck. The teeny bit of soup had to come up, and the droolfest began. This time, the slime monster hung out for over an hour. Fun. But not really.

I hit the couch and watched 2 episodes of The Biggest Loser to keep my mind off of the slobber. Fortunately, my fat brain was not interested in food in the least. It's about damned time.

Later in the day I was able to get down a cup of cocoa made with Carnation SF Instant Breakfast and skim milk. So I thought all was happy in Bandy land, and that I'd try some baked ricotta.

Yeah, it wasn't happy down there after all.

Two tiny tastes of that and kapow! Attack of the Slime Monster yet again. This was growing old fast and I was really starting to worry. I can't get anything down. I'm afraid to drink. Can I get through the weekend without a visit to the ER?

This Slime Monster visit ran almost 2 hours. Seriously? I haven't had more than 8 oz of fluid since Friday. Where am I getting all the juice to make drool from?

I found lying stretched out on my side in bed made me feel better, so my spit cup and I called it a night. At least I was able to swallow my own spit and get a relatively decent night's sleep.

The Fill...

Oh this story is a long one! I'm writing it because I want people to see the real side of lap band life. There can be issues with the band. Most don't have them, but for those of you who might, I just want to remind you that you're not alone and that we can get through it!

I went in for fill number 6 on the 4th of November. The new attending, Dr. Foster, was doing fills that day. I love this doc! She's so personable, funny, sympathetic and understanding. We were all joking about girl power in the procedure suite. Who needs those crazy boy docs--they're not anywhere near as fun!

I let her know up front I'm a challenge. My port is twisted just over 20 degrees and I am a scar tissue making machine. It took her awhile, but she finally got in there. We both kept reminding the nutrition intern who was watching that this is not normal. Usually they can get in the port quite easily. I like to make it a challenge to keep the docs on their toes.

Dr. Foster was great and was pretty aggressive with the fill, adding 1.5 cc to bring me up to about 8.5 in my 10 cc band. I was able to get the barium down with no reflux into my esophagus, so we wrapped stuff up and I went on my merry way.

Thursday and Friday went pretty well. For the first time, I had to sip, sip, sip. I knew that if I didn't, it would overwhelm my pouch and things would not go well.

The current post-procedure protocol is 2 days liquids, 2 days pureed and 2 days soft foods before working your way back into the regular textured diet. The 2 days of liquids went pretty well. I had a few moments of, "whoa!" but I was very excited that the band was finally doing its thing.

Then I got to the pureed stage. Friday night (48+ hours after the adjustment), I tried some mashed sweet potato. Yeah, Bandy was not thrilled with that. Bandy got revenge on me (jeez, it was like 2 teaspoons!) by conspiring with my brain and salivary glands to throw me into Major Slime Mode.

I'm writing about this not to scare anyone off from having a Lap-Band, but to remind you that it's not a cake walk. Bariatric surgery is not the easy way out. There is a price you may have to pay when you have surgery and that comes in the form of complications.

I found out the hard way that I am a massive slimer! Basically that means when I get stuck, or my stoma gets overwhelmed by something trying to slither its way through, my stomach swells, sends a signal to my brain, and my salivary glands kick into overdrive. Normally, having a little extra pharynx lube is a good thing when you have something stuck in your throat.

Not so much when you have a Lap-Band.

The swelling caused by the offensive food particle does not like slime, either. It's incredibly viscous and can't fit through the swollen hole. So it has to go somewhere.

You're welcome, as I refrained from taking a picture of one of my full spit cups. I'll just let you know that it's gross stuff. And I could easily produce 16 oz of slime in one session. Not that I'm proud of that. Trust me, if I never produced another drop of slime EVER, I'd be a happy camper. Huge deterrent, on par with dumping syndrome that the RNYers experience.

It took about an hour on Friday night for my glands to slow down and for me to stop retching. Okay, fine. I'll take it slow and stick to liquids the rest of the weekend. My friend Debra said that she'd keep an eye on herself over the weekend, when trying to determine if she was too tight, and then go to the clinic on Monday. Sounds like a plan.

Sometimes plans don't go as, well, planned.

Monday, November 2, 2009

A few more days...

Until fill #6.

I really hope that this one helps, as I am getting very frustrated. I'm interested to see if he is able to pull off more than 6 cc when he checks the volume. I'm half ass wondering if there's a leak in my tubing or something. There's got to be a reason WHY I'm not feeling the restriction yet.

I'm really trying hard to do my best. Today, I took advantage of the time change and put in 20 minutes on the elliptical and did my hip stretches before I did anything else. In spite of needing to pee desperately, I took the long route and walked in from the parking lots instead of taking the bus.

I hauled in yogurt and high fiber, high protein cereal, a container of calcium lozenges and of course my food journal. Brought my lunch (chili with some 2% cheddar for the top) and am drinking my Crystal Light.

I'm trying hard today to work my tool. Now if it could just reciprocate.

Friday, October 23, 2009

More thoughts from support group

I just want to write this down before I forget it. One thing that really made me think last night was that it's time for a paradigm shift.

I will clarify and say that my band is not giving me restriction yet. But, I do think I need to revisit my definition of full. Pre-op, my definition of full was I'm in pain. Discomfort. If I wore pants, unbuttoning them (I wear skirts, silly. Get your mind out of the gutter!).

Jessica pointed out that we need to think of the sensation we are looking for to be more satisfied than full. It's enough. I'm content. I'm not hungry any more.

Interesting how my perception of full is negative (pain, discomfort) while satisfied is positive (content). Could there be something to this new line of thinking?

Right now I am having a huge battle of wills. Shockingly, my banded stomach is still content from lunch (which was a mega sized salad with chicken) but my head is dying for some yogurt with Kashi. Instead of indulging in that 150 calorie treat (Kroger Vanilla Carb Master Yogurt + 1/3 cup Kashi Go Lean Honey and Almond Flax equals 150 calories, 3 g fat, 16 g carb--8 g fiber--and 15 g protein), I am focusing on writing to distract me, plus drinking lots of Crystal Light while reminding myself, this is what your head wants, not what your body needs. The yogurt and cereal will be there when you actually are hungry. It's not like now or never. Sheesh.

Dear Head, just shut the hell up.

So far so good. Can I continue to pull this off and survive the battle over the next two hours? Only time will tell.

If that doesn't work, then I'll remind myself of another Jessica-tidbit from last night. She said, "What part of the memo that we are no longer eating for fun did you not get?!?"

I'm half tempted to put that on the cover of my next food diary! I just started a new 3 month one, but I definitely think I will write that inside the front cover until time for a new one!

Outsmarting myself

Long time, no write. I'm 28 weeks or just over 6 months out from my surgery and am at a very slow spot. I haven't really lost anything in 3 months. Just hanging in there.

I truly believe the band will kick in at some point, but it hasn't yet. I find this immensely frustrating. I can eat dense protein until the cows come home, but unless I don't chew well, it goes down fine and doesn't fill me up. Ugh. I attribute this to yet another medical goofiness. Typically, if there's a stupid side effect that 0.01% of the population gets, or a bizarre complication that's only been seen 3 times in recorded medical history, I get it. My band is no different.

I have had 5 fills and still am not in the "green zone." Most people start getting the sensation of restriction (fullness that helps you stop eating) at 3 or 4 fills, though I've heard it can take as many as 10. Ideal restriction with the band means you can not really eat more than about a cup of food and that cup of food makes you feel full for about 4 hours.

I'm scheduled for fill number six on the 4th of November, which I am very much looking forward to. Initially, my clinic was doing more aggressive fills, closer together. About 1.5 cc per adjustment, though even that is conservative by some clinics' standards. Now they're less aggressive (0.5 cc per adjustment) and the fills are farther apart, now at 6 weeks. Sigh. Until you get restriction from adequate volume of saline in the band, really, all you're doing is dieting.

I've been dieting for a year now (my initial consult with Dr. Williams was on Oct 3, 2007) and my willpower gave up about 3 months ago, when I was dealing with a stressful dog situation at home. I fell off the wagon amidst all the stress, and though I've been lurching along behind it, I haven't had the energy to jump back on board fully. No time like the present, though.

Last night was the October edition of The Missy And Kenny Experience, a SWL support group. Both Missy and Kenny have had the RNY surgery and they are just under a year out. They're witty and insightful and make for great group leaders. As always, last night's group did not fail to disappoint.

I took lots of notes in my journal and most of it was about getting my head back in the game until the band feels like showing up to play. One of the amazing women at the meeting was discussing her challenges a few years out from her surgery and mentioned the oft repeated phrase, "They do not do surgery on your brain." I knowwwwwww. I wish they didddddd!

Her stories made me reflect on how crucial thoughts are in this game. I can either roll up in a ball and say to hell with it and wait several more months for this band to kick in, or I can step it up now. I really need to step it up. I've spent the last 40 years rolled up in a ball and I'm sick to death of that.

So it's time to stop farting around and get with the program. The band will hopefully show up at some point, but I have to stop waiting for it.

The going has been rough the past several weeks. Once I got the dog situation remedied, I chilled out a bit, then started my morning routine of closely monitoring my blood sugar, being fastidious about my meds and skipping the shuttle buses in order to get two 20 minute walks in daily.

My morning blood sugar tends to be high, running around 150-160. My endocrinologist and I have been tweaking meds to get that improved. If my morning reading is >150, I have to take insulin, usually 4 units. This got my sugar level down fine, but when coupled with a morning walk after breakfast/before work, my sugar would plummet too low. I'd have my daily crash about 10:30, often having readings in the mid 80s. For me, that's really low.

I dealt with troubleshooting the blood sugar for a week or so . . . the low blood sugar episodes threw me off and I felt compelled to eat to make the shakes go away. I finally tried cutting my insulin back to 2 units, and that worked great! After my breakfast and walk, my sugar was down to only 100--no shakes or cold sweats! And after a few weeks of diligent tracking, there were a few mornings where I didn't need any at all!

Once I got through the blood sugar issue, then I hit the ravenous phase, which I am in right now. As I said before, the band should help you feel full after a limited amount of food, and that sensation of satisfaction should tide you over for about 4 hours. Also, you really should just be eating 3 times a day, preferably with no snacking.

Yeah. Not so much. I was stomach growling hungry (SGH as I call it in my food journal) by lunch time, even with a low carb, high protein yogurt + cereal snack mid morning. And forget the afternoons. I'd sit there and rumble and growl and have a protein bar about 3pm. I would drink 64 ounces of Crystal Light while at work.

By the time I got home at night around 7, I was so ravenous I could have eaten Jack! Mmmm, meaty! Once I got dinner made and sat down, it was like I couldn't stop. I got the band because I'm a volume eater and it was supposed to help you stop. Not yet, but I'm still hopeful.

Each night now, it's like a switch is flipped when I sit down to eat. I have an incredibly hard time stopping. I want my band to step in and help some, desperately. Until that day, I've got to come up with some kind of proactive attack plan to walk away from the food, signal to myself through my head (not my stomach) that the eating is done.

I'm having to figure out how to outsmart myself.

I told my nutritionist Jessica about my latest tactic. Each night before bed, I prep Kongs for Jack and Map. Just poking a cookie in there is not enough to keep them occupied for long. So I had taken to smearing some peanut butter in there. But I was smearing peanut butter for Jack, then eating some peanut butter. And smearing a little more for Map, then eating more for me. 2T of peanut butter is nearly 200 calories and 16 grams of fat! I was doing that--or more--without thinking about it, right before bed. Every night.

I decided it had to stop. But how? Deny the dogs their treats? I tried switching to cheap peanut butter, but I liked that even better! Less thick and sticky than my treasured Jif. Sigh. I decided to switch to cheese. But not cheese-cheese. Canned, aerosol cheese-like foam!

I'm not a cheese snob in that I must have a lovely melted brie or smoked gouda. But I'm not a processed cheese food person, either. So there's no way I'm eating that canned crap! I'll feed it to my dogs (ha!) but I'm not inclined to taste it at all. I got the canned cheese, thinking it might be cheaper than the spray foam peanut butter (equally not appetizing) by Kong, but apparently it's not. So I'll switch to a more dog appropriate, lower sodium product after pay day.

At least for now, though, the Cheez-Wiz keeps me from eating a big gob of peanut butter at 10 pm.

One mental monkey off my back . . . how many to go?



Thursday, October 15, 2009

I. Am. Starving.

I have really neglected my WLS blog--sorry! I've just been all over the place and haven't had much time for any kind of blogging. I guess for now, I'll start with today and work back in time.

I am just over 6 months out from surgery and one of those lucky ones *sarcasm!* that is going to take forever to get decent restriction. You know, it's gonna take a lot of juice in my band for me to feel full. And I'm not really losing any weight.

My next fill is not until the 4th of November, so I have about 3 more weeks of being ravenous (or eating enough to not be ravenous and maybe gain 5 pounds). I'm going to do my best to behave, but without restriction, it's not an easy task.

Lest I be chastised at my next visit, I should switch to the politically correct terms pertaining to my band:
  • I don't go in for fills, I go in for adjustments
  • I will not hit the sweet spot, I will someday enter the green zone
  • It is not juice in my band, it is saline
Whatever! ; )

While I patiently wait for my band to WORK, I have worked on getting focused. It was quite easy right after surgery and until I got on solid, normal diet. Since then, it's been very tough. I'm very happy that other people get restriction (are in the green zone) a few fills out. I just wish I'd get there. 6 months later with no restriction is a big, fat pain in the butt. I know it's not super common, but it's totally a PITA when it happens to you.

In my plot for success, I am trying to set up my environment to help rather than hinder. I put a picture of me 60 pounds ago and a current picture side by side on my fridge.

Photobucket

I bought fresh vitamins and calcium in tastier flavors. I got a new edition of my food journal that has enough pages for 3 months and has a snazzy cover. I carry it EVERYWHERE and it is always lying open to the day's page. If it goes in, it goes down on paper. Helps me think twice about grabbing impulse food, especially realizing how much I've already eaten so far today.

I've also ditched the shuttle bus and have been walking 20 minutes twice a day. And drinking at least 64 oz of Crystal Light.

Being stomach-growling hungry (SGH) is annoying. But it's not like I'm gonna keel over or anything. Plus, by not going crazy at night, I have had good morning blood sugar readings the last two days in a row! Normally, I have to take 4U of insulin each morning. Now I take NOTHING! We'll see how tomorrow goes and if I can make it 3 days running.

Wish me luck. Or intestinal fortitude to not fill my cavernous, gurgling belly!

Monday, August 17, 2009

STOP THE PRESSES!!!

I don't want to get overly optimistic, but I think my band may be working some. (keeping fingers crossed)

Last night I went overboard and I knew I should have stopped eating, but the head won out. And boy did I pay for it!!!

I was in absolute bloated misery hell for a solid two hours. Ugh! All I know is that I do not want to knowingly eat myself into that situation again. I finally got myself into a comfortable position and attempted to watch TV. Food commercials practically made me gag.

FINALLY--CONSEQUENCE!

I have been waiting to get consequences for my eating actions since April. Now it seems I may be close to it. Because feeling that crappy is the only thing that will stand up to my flaky thoughts that encourage me to eat-eat-eat. Up to now, the easiest thing to do has been eat, just to shut that voice up. Now, I have an incredible reason to say no thanks.

I do not plan on testing the limits of my band again any time soon. Last night was enough for me. In spite of the extreme discomfort that lasted so long, I am thrilled!

(good grief--how long have I been gone? The text editor has changed! Where did my justify text option go? sniff, sniff)

Wednesday, July 8, 2009

Weight Watcher Cat Says . . .

Someone posted this on OH today and I found it to be quite hysterical:



I just thought I'd share. I'd write more but then I'd run out of time for the gym. With this week's insane schedule, I really must go work out while I can. More antics later!

No points left,chubby. Baahahahaha! I need a WW cat to live in my fridge!!!


Thursday, July 2, 2009

Good laugh!!!!

Tammy on the TN board posted a link to a website that calculates your ideal body measurements based on your wrist size.

It says I should be 40"-28"-34"!!!

I cannot stop laughing!!!! Is this before or after my boob job?? Saggy, rolled up boobs or perky plastic boobs??? With significant weight loss, boobs tend to lose volume or deflate. Long boobies. Just the thought of getting geared up (hoist and stuff) to measure cracks me up!

Whew. Finally calming down. Those are a lot of inches to lose. I'm almost 3 months out and my clothes are quite saggy. My beige skirt with brown and red print practically fell off me on Tuesday. So I know I've lost a lot of inches. I couldn't even zip it up all the way last year.

Perhaps I should measure up next week and see where I'm at. I'm totally sure I'm not 40-28-34 (hahahahaha!), but I know I am not 51-50-54 anymore, either.

I can't wait to get home to my MyoTape!!!

Dear Diary!

I have had 4 stuck episodes since my last fill.  Some of them are due to seeing what my tighter band will tolerate.  The others are because I'm not cutting teeny bites and chewing them like I should.  I'm still new at this and there is definitely a learning curve, especially after fills!

Last night, it seems I have shown to myself I can indeed listen to the band's messages!

I was over hungry yet again when I got home.  I wanted to work a bit with the puppy Millie, so I got some rotisserie chicken (yeah, got stuck on that the night before) out to work with her.  Our trainer Kat says if you want them to learn the fastest, use really high value treats.  She's right.  Millie will really work for rotisserie chicken.  For kibble? Not so much.

Anyway, the chicken was soooooo good.  A tiny bit for Millie.  A tiny bit for me.  Lather, rinse, repeat.  After a few bites, I felt that twinge behind my sternum.  OH!  That means STOP!  

Guess what?  I STOPPED!!!!  No sliming, no PB.  Just a few minutes of discomfort until the chicken chunk settled.  I waited awhile and then all was fine in the world.  Ahhhh.  I'm definitely going to get the hang of this thing eventually!



Friday, June 26, 2009

A monumental day

I weighed in this morning at 214.6 pounds.

I have not been this small since my brother's car accident and subsequent death in November of 2000.

At that time I was working with Jamie Pope, a Vanderbilt dietician who teaches in the Nursing School and ran the weight management program through Health Plus. Her lectures were great and I still remember so many of her gems of wisdom. She got me on the food diary bandwagon and gave me great feedback.

One of the topics she discussed was that if you look back at all the pivotal times in your life, you can see how it often tracks with your weight. Break up with your boyfriend, weight goes up. Battle depression, weight goes up. Got new job, weight goes down. Things like that. Life happens.

I was at a very motivated point in my life and had lost about 40 pounds through that program. Then life happened and all bets were off. I will say it was one holiday season during which I didn't gain any weight! But then again, I distinctly remember seeing the scale stuck at 215. I thought, gee, I can't eat because of my anxiety about all that was going on. You'd think I'd at least lose a few pounds. But I didn't. The scale would not budge below 215 and after Bubba died and the post-traumatic depression set in, I put on 59 pounds over the next few years.

I had my breaking point last fall when I saw myself in the mirror at a friend's house. I called the next Monday to get an appointment with a bariatric surgeon. And today I am down 59.4 pounds and 0.4 pounds under my lowest adult weight in the last 10 years.

Yes, losing weight with the Lap-Band is a slow and challenging journey. But I wouldn't have it any other way. I am very proud of what I've achieved so far.

Wednesday, June 24, 2009

Pretty sure I was born with a tail

One of my favorite Family Guy scenes is with Lois and Meg rummaging through stuff in the attic.  Lois says to Meg in her nasal, New England accent, "Oh, look, Meg, it's your little baby booties.  Oh, and your little bronze hat.  And your tail."

My WHAT?  

I am pretty sure that I was born with a tail.  Just call me Meg.  

One day I was standing in the kitchen, scratching my butt.  You know that upper butt dimple region* just above the crack proper.  I shifted my weight and all of a sudden I felt this pointy thing--what the??  My butt was also sore and I immediately jumped to the conclusion that I had a pineal cyst, which had been the topic of discussion a day earlier on my favorite weight loss surgery message board.

Of course I am immediately intrigued by anything gross and pineal cyst certainly fell into that category.  You're welcome.  I did not put a link to the pineal cyst entry in Wikipedia, which has a lovely color picture. Yeah, no one warned me, thank you very much.  Do not Google this and look at images.  If you do, you get what you deserve.

Anyway, the pineal cyst discussion lead to a delightful and energetic series of PMs on dermatoid cysts with a gal named Karan, who might actually have one!  I'm sitting on pins and needles waiting to hear if a.) it is indeed a dermoid cyst and b.) if it has hair and teeth!  YIKES!! But I digress.

Initially, a sore butt in the upper butt crack dimple region (UPCDR) made me suspect a pineal cyst.  But after a day or two, I decided it was not the case and my bum was sore from riding the recumbent bike at the gym, instead.  Whew.

So if my sore behind was due to the bike rides, what was the pointy thing?  The end of my tail???  I wish I were friends with an x-ray tech. Psst.  Can you get me in there for an upper butt x-ray?  Oooh, maybe we can sneak into the fluoroscopy suite tomorrow after the support group meeting.  Do you think you need a key to fire that thing up?  Oh the quandry!  Why does this weirdness always happen to me?!?

The issue is there is no way I would have survived childhood without being reminded constantly about my tail, had I had one.  We love picking on each other about stuff like that.  My mother can say once in passing, "That water is as green as green can be," and BAM!  It haunts her for life.  So it goes without saying that if I had a tail, I would have been reminded of it with great frequency.  My brother would have had a field day with that knowledge!

So now I have ruled out pineal cysts and am left with two options.  #1: I had a tail.  #2: Losing almost 60 pounds makes your ass bony. Relatively speaking, that is.  Losing my posterior padding is doing a number on me.  I can feel the bones in my behind and sitting on them for hours on end is not comfy.  Freaky!  Do skinny people writhe in pain constantly from this?  Do fat people on the downslide always go through this fanny transition?  I prefer to sit on my hips now, legs crossed at the knee.  It takes the pressure off the butt bones.

Perhaps I should take a moment to review hiney anatomy.

Huh.  Maybe that thing I felt is one of those ridges at the top of the tailbone, which seems to correspond with the UBCDR.


Nevermind.



*  I don't even know if the upper butt dimple region is normal--this could be where my tail was removed!  I need to borrow Angela's kid and inspect his baby butt to see if he has one.  An upper butt dimple region, I mean.  Not a tail.  She SO would have told me about that!

SUCCESS!!!

I am capable of following directions!!!

When you go through all the preliminary instruction prior to your band installation, they hammer into your head, "CHEW, CHEW, CHEW! SIP-SIP-SIP!" And like I mentioned previously, they say eat tiny, pea sized bites.

When you are in bandster hell, it is hard to do this. If you have no restriction, what's the point? Nothing bad happens if you eat fast or don't chew super-duper well.

Ahh, Grasshopper. Funny you ask. The point is that you will need this skill when you GET restriction!

I have had a rough few days of getting stuck, learning what Bandy will and won't tolerate with ~4.5 cc in him. First with the dried out hamburger patty, then snarfing down some fresh deli turkey and last night with my oh-so-yummy grilled chicken. I decided the common denominator in these episodes was me not truly getting the chew-chew-chew thing. So I took a chance and decided to try my grilled chicken and veggies for lunch.

It took me half an hour and a whole lotta chewing, but I got it down, got to enjoy the delicious, fresh flavors and best of all, I did NOT GET STUCK!!!

When they say pea sized, they MEAN pea sized. Duh. I am capable of learning, but sometimes the learning is slow going. I blame all the x-ray radiation from that fill! Yeah, that's it!

I'm just overjoyed that I can continue to eat my precious, grilled chicken. If that was not an option, I'd be very sad. Whew.

Tuesday, June 23, 2009

Three strikes!

Apparently Mr. Bandy is PMSing.  He is not amused.  Nor am I.

Yesterday I had the stuck episode with the hamburger.  This morning I went to the deli to get some turkey for my turkey roll ups (Boar's Head Lower Sodium Oven Roasted Turkey breast rolled up in a slice of Boar's Head provolone cheese--YUM).  Publix always gives you a sample when they cut the first slice.  I ate it too fast (we do not seem to have the hang of pencil eraser sized bites and CHEW-CHEW-CHEW) and boy howdy, it got stuck!

I walked around the store and picked up my other items.  Still hurting. Fortunately the parking lot was deserted at that time of morning and I could slither up the tiny bit of turkey by the door of my car.

I was very worried at lunch and wondered if I'd be able to tolerate it. This is the thing:  it's a learning curve.  What can I get down, what does the band not tolerate?  So far, he does not like over cooked hamburger patties and he does not like poorly chewed, snarfed down turkey meat.

Let's add number three to the list:  poorly chewed, snarfed down grilled chicken (notice a theme here?).

I am just now starting to feel better after this episode.  

I needed lunch for tomorrow and Thursday and had thawed some chicken.  I love to make this Greek style chicken that I marinate in a bit of canola oil, red wine vinegar, dehydrated onion, dehydrated garlic and lots of Greek seasoning.  I serve it with grilled veggies--zucchini, mushrooms and red pepper that have been sprayed with olive oil Pam with a dash of garlic salt with parsley.  OMG, I LOVE THIS and I could literally eat it every day.  The girls at lunch are likely getting tired of my in-chair happy dance I do the entire time I am eating.  But it is that good!

I prepared all the veggies (using my own, home grown zucchini I might add) while the chicken was marinating, then fired up the grill. Yum.  The smell was incredible, which is a good thing because my back yard reeks from composting grass clippings.  Yikes!  But that's a totally different blog entry.

I brought the chicken in and cut off a bit.  Note to self:  eraser sized = pea sized.  Not the big pink gum eraser size, thank you very much! Tried to chew it as well as I could, but I was so excited about it that I snarfed it down.  And then I had a few bites of grilled red onion. Drooool.  So good.  

Then the pain hit.  Awwww, damnit.

The kitchen sink and I have spent most of the last half hour bonding. I was finally able to pack up lunch for tomorrow and put it all away without eating it.  But it tasted so good!  It was quite a challenge, though I confess I DID lick my fingers.

The ickiest part is the drooling.  It wasn't copious, but it was enough to overfill my pouch and that had to come back up.  One thing I know without having to make the mistake on my own is DO NOT TRY TO WASH THIS THROUGH THE BAND WITH SOMETHING TO DRINK!  Unless you really want to spend some quality time leaning over the sink.

We will see if I can eat this tomorrow for lunch.  I will try a single, pea sized piece of chicken, I will chew it into oblivion and then I will wait and see before anything else goes in.  Because I haven't had restriction until now, I haven't really understood the tiny bites and chew-chew-chew thing.  Until today, I mean.

I have a back up plan (cottage cheese and tuna) just in case.  Or I'll just do yogurt and protein drinks and give my pouch a break.  I did tuna and cottage cheese at lunch today with no problems.  So I know I can eat solids!  I just have to learn to play nice with the band and his newfound tightness!  

Definitely a learning curve, but the band is finally starting to do what he was put there for.

Monday, June 22, 2009

When the band says no, he means NO!

And the band is not keen on overcooked, reheated hamburger patties. Don't do it.

Today I had my first episode with things not well tolerated by my band. I've had hamburger before, but I think these patties were just too cooked and then reheated on top of that. What I need to realize is if I have a stuffy pain behind my sternum, quit while you are ahead! That sensation is that things are backing up and after the first bite, you need to stop.

We were having a party today for one of our pals who was bringing in her 7 week old baby. He's a hoot! But in true lab fashion, they planned a pot luck. I just did not want to be faced with temptation, so my plan was to eat at my desk and then go hang out for the party. So I popped my hamburger patty and slice of cheese into the microwave for a a quick reheat.

I ate a few bites and after about the 3rd bite, I started to get a pressure-pain behind my breastbone. I figured it'd just settle and go down momentarily. So I plodded onward. What was I thinking???

Now I know this pressure sensation is the logjam building.

I ate about 1/3 of the 4 oz patty before giving up. At that point, I was not feeling well at all and even spit out the last mouthful because there was no place for it to go. I had to stand up to try and relieve pressure and ended up spitting onto my lunch plate and pouring it into my trash can. I apologize in advance to the guy doing housekeeping tonight!

Vomiting post band is interesting. There is no heaving, no acid. Just a burp with a slither. After about 3 of those, I felt a bit better, but just kept standing, leaning against my chair. I was not very into the party after that, but at least I was able to stay away from the food, ha ha!

This is not a good thing to do to yourself. But I am glad it happened this one time. First off, I know that my tool is in there doing its thing. Secondly, I know that if I ever encounter that feeling again that a.) this food is something I do not tolerate and b.) STOP. I know that if that feeling persists I am actively doing damage to myself, potentially stretching out my little pouch and creating risk for future slippage issues. Did I mention STOP?

So all's well that ends well and I'm glad to have clearly learned one of the signals that the band sends me when it's not happy. Lesson learned!!!

Oh, here's a picture of me and the kiddo. You can't see it here, but he has a big baseball right over his booty! TOO CUTE!!! You can't really tell that I've lost much weight in this photo, except in my face. It's obscured by my granny work-bathrobe jacket that I was wearing so I didn't freeze to death in my meat locker-like office!


Friday, June 19, 2009

BMI update

My scale is on the move again and I wanted to see how my BMI has improved.

When I started this journey, I was morbidly obese and knocking on the door of super morbidly obese (BMI >50).

Highest = 46.3, morbidly obese
At my first surgical consult date = 45.3, morbidly obese
Today = 36.7, obese, class II

I'm only 1.8 units away from being just plain obese. That puts me on the fast train to overweight! Oh yeah!

Here are some weight loss goals:
  • Goal #1--Lose 12 lbs to get to official Just Plain Obese status!
  • Goal #2--get down to 175 lbs so I can be merely overweight!
To get to simply overweight, I need to lose about 43 pounds from where I am today. I can do that. It may take me 4 or 5 months, but it is totally doable. For now, though, I'll just focus on losing 12 pounds and will celebrate gleefully when I am officially in the least of the obese categories!

10 weeks and 2 fills

It's been 10.5 weeks since my surgery, though it feels much longer.  I guess that's because the recovery and getting back to normal life has been so easy.

My 2nd fill was Wednesday evening and I am down about 2 lbs since that morning.  Yay!  The scale is on the move again.  

I am enjoying the fill at this point, though some of the restriction might be due to post-procedure swelling.  That's okay, for now restriction is restriction!  

I did liquids for 24 hours after the fill and last night had my first food--a scrambled egg, 2T of shredded cheese and 1/4 cup of 2% cottage cheese.  It filled me up and my stomach was NOT growling this morning!  That's cool!  

That much food (relative term--that was nothing compared to my normal intake) was almost too much.  I know if I had a few more bites of something it would have been too much.  I was full but not uncomfortably so.  I didn't have any reflux or PBs, but I almost slimed.  I was making a lot of saliva and had to do a lot of swallowing after dinner, but nothing else happened.  

NOTE TO SELF:  if you're drooling, you'd better stop!  I'm trying to listen better to my body for signals as to when to stop.  My old signal was, damn:  plate empty.  Now I need to tune in and feel what's going on.

I'm really pleased today, though.  Whether I reach the sweet spot with 2 fills (doubtful) or if it takes several more, I think last night was a glimpse of life to come.  Being satisfied on a small amount of food and having it stick with me for hours.  Yeah, now THAT is what the band is all about!!!

Thursday, June 18, 2009

Still starving, though

One thing I didn't realize prior to surgery was that every time you have a fill, you have to go back to the beginning. As in liquids for 24 hours post procedure, then a little mushies, then work your way back up to regular diet. You don't have to do it the slow way you initially do after surgery (clear liquids 24 hours, full liquids several days, mushies 2 weeks, soft stuff for 4 weeks then regular diet), but it's the same course of events but in rapid fire fashion.

I could probably go from straight liquids to regular diet if I wanted to, but I kind of like starting from scratch and using this moment as what I refer to as a "soft reset." My computer didn't crash completely, but it did start acting a little wonky. Especially when I realized I had absolutely no restriction and could pretty much eat anything. Whew! The fill came just in time.

I am embracing this opportunity to get back to the basics and the same level of dedication I had immediately after surgery. Because I don't have to think about food (basically pop open an Atkins shake or carb master yogurt), I am making myself get back into journaling my eating and checking my blood sugar multiple times a day. I just checked it and it was 123 mg/dL--yippee!

I have learned so much on this Lap Band journey. One of them is that I need my training wheels and may need them for a long time to come. That, for me, is my food journal. If I don't actively keep one, it's like out of sight out of mind. I lose track of what I'm eating, I don't measure and I over do it. So using my food journal is a must. And it might be a must for life if I want long term success.

Today, however, I am starving! I will have a soft scrambled egg and some cottage cheese for dinner, but I have been doing liquids and yogurt all day. There is not enough liquid in this world to keep my stomach from growling!

Right now I'm at 340 calories, 21g fat, 16g carbs and 42g protein for the day. By the time I add my egg and cottage cheese for dinner, I'll probably end up between 500-600 calories and close to 60g protein.

From the morning of the fill to this morning, I was down 1.2 lbs. We'll see how this keeps up!
For now, it's just dealing with the rumble. It's just part of this bandster's life!


A compliment!

Tuesday got her annual shots on Monday. Because of her extensive health problem last year (the pyometra, blood loss, transfusion and hemolytic anemia), she is susceptible to having another episode of hemolytic anemia brought on as a side effect of her vaccinations. It's something we have to look out for every year for the rest of her life. Dr. B said to keep an eye on her mucous membranes, as paleness of her gums would be indicative of a problem.

Last night Tuesday and Map got to snuggle in the bed with me. Though after an night of battling Perpendicular Dogs, that may not continue! When we got up, Tuesday yawned and her tongue was very pale. Last year, when she had hemolytic anemia, her tongue was white. That scared me to death and I couldn't get the 20 miles to the vet fast enough!

Seeing her pale tongue made me think that a trip to Franklin for a packed cell volume test was in order. Just to be on the safe side. I'd rather err and be wrong than wait and have her get really sick. I called and talked to Rebecca, one of the gals on staff. She said to just drop her off and they'd squeeze her in.

The file they have for my crew has my name as Mary on it, but I go by Denise. (thanks for making this an eternal pain in my butt, Mom and Dad!) When we went in, Rebecca did a double take and said, "Oh, I almost didn't realize it was you!" I assumed she didn't put the face with the folder name or something. Then she went on to say, "because you've lost so much weight!"

Wow! I thought she was confused about my first and middle names. Instead, she almost didn't recognize me because I look different after losing 50-odd pounds! How cool is that?

At first I thought Tuesday faked early morning paleness so she could get some more loving from her friends at Caring Hands. Instead, she found an unexpected compliment for me! I love Missus Tuesday!!! She's my special lady!

Wednesday, June 17, 2009

COOLEST THING EVER!!!

I had my first Lap-Band fill under fluoroscopy today and it was the most super cool thing I have ever seen.  I love my RNY friends, but their surgery does not provide this level of entertainment for the easily amused.  OMG!!!

Today was a pox on my ass until I got into the fluoro suite.  I actually made a list while I was sitting in the maniacal atmosphere of the diabetes clinic.  Perhaps I'll share that on my other blog.  But the day kept on being a pain, as I went from the main hospital, to the allergy clinic (my arms are killing me from the shots!!!), to the mall where the bariatric clinic is.  I hoped to squeeze in a mammogram (get it?  Squeeze?  Mammogram?!) while waiting for my 3:10 pm fill appointment, but I ran out of time.  And by the time I was finished with the fill, the breast clinic was closed.

But that's okay, because I wanted to hurry home and upload my video!

First, they had me lie down and spent lots of time jabbing me.  My pork was not being helpful and Dr. Carpenter had a hard time getting in there.  Finally, Dr. Williams came in and helped get things going.  I don't have any images of the port shots because I had to lie down and behave.

For fluoro-fills, they use a long length of tubing attached to the needle instead of the syringe directly attached.  This makes standing up and walking around the room MUCH easier.  They got me positioned in front of the x-ray and took a picture to make sure I was standing in the right position.  The squeal you hear when the video starts is me laughing when I realized you can see the hooks of my bra and the lovely underwires!  Baahahahaha!  Oh, also you can see my scoliosis where my spine kinda bends to the left.  Lovely!

So they had me drink a swallow of the barium icky juice.  You can see it (black on the x-ray) go down my esophagus, hit the band and then squirt right through!  I new I didn't have any restriction and I think even the docs were a tad surprised at how quickly that stuff shot through the stoma created by the band.  If you look closely, you can see the band as a dark shadow, kind of canted on a 45 degree angle before the collection of barium in my stomach. Just south east of the bra hooks, if you will.  He added 1.75 ml to my band initially but with that much saline, stuff pretty much came to a screeching halt once it got to the band (about 2:50 in the video) and settled in my esophagus.  

So he pulled out 250 ul and left me with an extra 1.5 ml.  You can see at around 3 min 30 sec in the video that the barium slows down and goes into my stomach instead of chilling in the wrong spot.  But it doesn't zip through the stoma, either.  

I've had 3 ml added to my band in 2 fills.  There was probably about 1.5 ml added at surgery, so I have approximately 4.5 ml in my 10 ml band.  I can't wait to see how things work now, eating wise.  I'm on liquids today and tomorrow, then I'll progress back to mushies on Friday. The real test will begin as I transition back to solid food.

I'm sure it'll still take a few more fills to get to the fabled sweet spot, but having some restriction is better than NO restriction.  And just getting to watch my innards is the coolest thing ever.



video

Friday, June 12, 2009

TGIF!

It's been a long week and somewhat tedious. I'm kinda glad the weekend is here! Not sure if I'm going to Cincinnati tomorrow . . . if my pal Carra wants to go, I will, but I won't go to the corgi club meeting by myself. That's too long of a drive filled with too many opportunities to hit a drive through! I need to clean house, anyway.

Yesterday was our monthly lap band support group and it was fun. I was a blabber mouthed chatter box the whole time. It was great because there was another post-op there! Though I don't recall her name, she was really nice and was a mere 10 days out from her surgery. Oh, I remember the old days! You know, like 2 months ago!

I did corner my dietician Jessica and had her set up the fancy-schmancy scale for me to weigh in on. I've been going to the gym for two weeks now (like every weekday) and I wanted to check my body composition. Though the scale has not moved much since my last visit (only about 4.5 pounds), my body fat has decreased by 1.6%, I've lost 6 lbs of pure fat and gained about 1.5 lbs of muscle. Oh, yeah! That I like!

I go back for my next fill on Wednesday and I cannot wait! I have been much better focusing on eating right the past few days, but it is a challenge with no restriction. It doesn't even feel like I've had weight loss surgery, truth be told. I'm still in that bandster-hell, between surgery and when you hit that restriction sweet spot where you can't eat tons of food. My 2nd fill will get me that much closer to the sweet spot. And because it's done under the fluroscope, Dr. Williams will be able to do a bit more aggressive of a fill. They'll make me drink barium (eew, gross!) and will be able to see how rapidly it flows from my upper pouch and through my band, into my stomach.

Just 4.5 more days!!! I think I can, I think I can!

And only an hour or so until I can go to the gym. I'm looking forward to that. I am finding it to be a nice, relaxing time of day. Even if 20 minutes on the recumbent bike makes my bum go numb!


Monday, June 1, 2009

A day that worked well

Not to imply that I have a lot of days that don't!  But I'm trying to incorporate regular exercise at the orthopedic center gym AND manage my food at the same time.  It's like trying to rub your belly and pat your head.  There are some times in life I'm not very good at multitasking!

I like how the day went and I wasn't overly hungry between meals, as in gnaw off your own arm.  It was merely nail chewing hunger!

Here's what I did.
  • breakfast before work--coffee, one scrambled egg and 1/3 cup 2% cottage cheese
  • lunch at noon--3 oz chicken breast, grilled veggies (mushrooms, eggplant, zucchini and red onion) and a carb master yogurt
  • dinner at 5--3 oz Boar's Head sliced low sodium turkey and 1.6 oz provolone cheese with 1/2 serving bagel crisps
  • dessert at home--water melon chunks
All told, that ends up less than 1100 calories and I believe over 80g of protein.  I haven't done the final totals yet because that would mean getting up and digging my food journal out of my bag!

As I said, I was hungry between meals but I was able to go between meals without snacking.  Usually I eat less at lunch and have my yogurt mid afternoon.  I decided to take turkey and cheese for an early dinner.  It is incredibly low maintenance (no cooking) and super delicious.  I could eat before going to the gym and not have to wait to eat when I get home.  Tonight, after a run to PetSmart to buy dog food, that meant 7:30 pm.  And I had to drive dangerously close to a McDonald's.  But I passed it.  Whew.

One thing about my schedule is that I hate eating dinner so late.  I'd really rather not eat dinner at 8 pm and when I do eat that late, it seems to open the door to make me wanna head hunger eat.  So today's experiment was a nice work-around that went well.  Eat early at work and just have a nice bit of fruit to top off the day when I get home.  

I am scheduled for another fill in a few weeks.  Hopefully once that is done, I'll have better restriction.  Actually right now, I don't really have any.  I had mild restriction in the mornings right after my first fill, but that seems to have abated.  

The goal of the band is to have you eat less than 1 cup of food at a sitting and feel full for at least 4 hours.  Not anywhere near there yet.  I haven't had any stuck episodes to date and have not had problems eating anything.  That's kind of annoying because not having restriction has given me opportunity to eat some things that I shouldn't have.

Just because you could doesn't mean you should.  But on occasion, I did.  This journey is not about maintaining an unrealistic level of perfection.  It's about learning what works and what doesn't.

Of course, adding focused exercise to the mix really helps.  It certainly makes you think twice about eating something not in your best interest when you spent an hour at the gym earlier in the evening.  I have certainly had a challenging evening battling head hunger, but so far so good.  And bedtime is imminent.

I'm going to apply today's format to tomorrow and see how that works.

What is going ON???

Pod people possession continues:  I just ironed a skirt.  

Like pulled out the ironing board, plugged in the iron and used it.  I even used the tape roller prior to ironing said skirt to get all the dog fur off it.

My interest in my appearance is quite entertaining!  My clothes are baggy enough;  I don't want to appear any sloppier.  Hence the ironing action.

Usually I'm like, meh.  Close enough.  Toss it in the dryer with a wet washrag.

Every day has new moments of self entertainment.  It's quite exciting to see what I might do as a result of these changes going on in my life.  Positive change breeds more positive change.

Beats the hell out of a downward spiral any day!