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!