On the ADHD Radar

Playing catch up here, trying to get to the present point in my adventures.

I was tested for ADHD on June 16th, and Dr. L told me I did indeed have ADHD, Predominantly Inattentive Type, on the first of July.  I was giddy about the news and had to keep myself from jumping up and hugging her!

She referred me to a psychiatrist in Franklin whom I lovingly refer to as Dr. Nyquil.  I had a great session with him and left that visit feeling more optimistic than ever.

First it was Tina at the allergy clinic.  Then Drs. L and Nyquil.  Just having a few medical professionals listen to you and actually hear you is amazing.  Feeling validated.  It's incredible.  Yes, my problems are all in my head, but not the way my primary care physician implies.  I had a wicked sinus infection and a brain chemistry issue. So there!  Neener, neener, neener!

Dr. Nyquil.  He's very professorial, glasses riding low on his nose.  He uses a bean bag desk on his lap behind his massive wooden desk.  He's got your folder on one side, your current list of medications on the other.

He'd tell me this patient vignettes, peering at me over his glasses, speaking low and methodically.  "I had a patient, 37 years of age.  Male.  Did well on medications."  or "I had a patient, 33 years of age.  Female.  Was fine until she had a child.  The stress of dealing with a newborn was more than she could cope with having ADHD.  Responded well to medicine and is thriving."

This is what he told me:  basically smart people with ADHD come up with a lot of coping mechanisms on their own.  They usually end up in a mental health professional's office because some stressful life event has elevated their stress and anxiety to a level where they've simply run out of effecting coping skills.

Aha!

Last year, when I begged the doctor at work for testing, I was dealing with an aggressive puppy that was picking fights with my other dogs.  I was incredibly stressed and couldn't get anything done in life.  Even getting to work was a struggle, until I finally took her back to the breeder and the stressor was eliminated.

This year, I was dealing with the whole weight loss frustration.  Yeah, I had surgery.  Not that you can tell.  What do I do?  Revision?  Suck it up?  Diet? Scream?

Also, I'm really bored at work.  Though I love where I am, it's not challenging in a way that I like, and it doesn't use my skills and talents very well.  I like to work with people!  Now I spend most of my time holed up in my office.  That had been eating at me subconsciously.

The push it over the edge thing was the chick with flip flops.  Well, actually they're high heeled plastic, plexiglass and silver lamé sandals, but her frantic scampering around the office might as well be Ricky Ricardo playing a ham with a couple of ping pong paddles!

I'm really sensitive to sounds (the psych testing confirmed it), and her frenetic scurrying was driving me nuts!  I couldn't block out the annoying sound and she wouldn't sit the hell down!  I spent a lot of time with my office door shut, eye twitching.

And that's how I ended up sitting in Dr. Nyquil's office, on the ADHD radar.

He said that about 85% of his patients respond well to medication, and I was gung ho to try.  Looking closely at my current medications, he decided we'd start with a low dose of Adderall and titrate up until I had a robust, therapeutic response to it.

The next day, when I took that first pill, my life changed forever.

Yikes! Where have I been lately?

I'll try not to make this post horrendously long, but I will preface it by saying a lot has happened since November of last year.

Where to begin?  I got ridiculously frustrated by my aftercare at the hospital where I had my Lap-Band surgery.  I ended up following in the footsteps of several of my other friend-patients and transferred to Centennial Medical Center, which I love.

I had another fill and my new doc is really good!  Even though my port has nearly flipped completely, he was able to get in and out faster than anyone that's ever tried to give me a fill to date.

Since the fill, I've been struggling.  I go from starving to stuck and sliming, which is not the ideal way to live.  What gives?  Why is this band such a beast for me?

Spring was quite fun for me, with travels to Texas and Boston, where I met up with many of my SWL friends.  But after the floods of May 2010, and getting back to reality, I realized I was sick of dealing with my band.  I want a revision to sleeve!

But . . . there's always a big butt.  I mean but.  I told myself that there would be no talk of revision until I made sure that I left no stone unturned when it came to my band.  Yeah, I know I'm having issues--is there anything I can do to fix them?  Give it the old college try and if nothing changes, THEN revision, here we come.

I went to a psychologist led group at Centennial, where I really liked the doc.  I signed up for private counseling sessions with her and within 20 minutes into the first session, she cocked her head and said, "Have you ever been tested for ADHD?"

(Brief pause where I smacked myself in the head and said I went to the psych clinic where I worked and BEGGED to be tested for ADHD, but was ignored and told I probably had some kind of underlying medical condition.  I hate doctors sometimes.)

One meeting with Dr. L and I was getting psych tests scheduled the next week, and two weeks later I was told some important things:

1.  I have Very Superior Intelligence™
2.  I have ADHD, Predominantly Inattentive Type
3.  Did I mention I was really smart?

Okay, I'm just goofing on the inflated ego from my IQ testing!  And the VSI is not really trademarked. It just looks more profound that way!


Long story short, the Lap-Band (or Realize Band) is NOT the ideal surgery choice for ADHD patients.  Who knew???  I found this out the hard way, after 15 months of struggling with essentially no significant weight loss after my surgery.  And a lot of sliming and puking.

Now that I know this and am getting my ADHD treated, things are changing.  And so will the direction of my blog . . . not just about surgical weight loss, but dealing with obesity and the ADHD brain.

Dealing with this has been a pain in the ass, but yet it's also fascinating.  I am more enthusiastic about life and my future now than I have ever been!

More stories to come . . .

Success and Failure

In spite of the awful time I've had dealing with my surgical clinic and the fact that I ate a lot of garbage to spite them (yeah, that's smart on my part!) over the holidays, my health continues to improve overall.

It's been 10 months since my surgery and I still do not have restriction.  I will get stuck if I don't chew well, but other than that, I cannot really tell I'm banded.  The clinic has now determined that since I'm further out from surgery, my fills should be farther apart.  Even though the band is not doing it's job yet.  Yeah.  Protocol says so, therefore it must be true.

So now I sit, frustrated, with two months between appointments, banging my head against the wall at my ravenous hunger.  Yeah, if follow up care for band patients is of this caliber across the board, no wonder why band failure rates are so high.

Despite my lack of success of weight loss at this point, I have turned a corner.  My last few months of feeling like crap is resolving with the treatment of my sinus infection.  I have a little bit of energy.  I've got some great events coming up in the next few months, like my Texas trip with Debra, and Carolyn and Anne's wedding in April, and all the great friends I'll get to meet at both events.  So emotionally, I am energized.

Anyway, my head is feeling better mucosally, and my mental health is feeling better as a result.  The two of those are dragging my body along for the ride and now I actually care about refocusing my fallen efforts at weight loss.

Yesterday, I had a follow up visit with my endocrinologist (ooh, I'm actually getting to the point!).  It went surprisingly well and my test results were a pleasant surprise because I really felt crappy and frustrated in December and was completely non-compliant as a patient.  I just didn't care.  Because I felt so bad, I was incapable of caring.

But the numbers were encouraging and now I am inspired to care.  Two helpful doctor's appointments in a week--this is a record!  HA!  Here are my numbers:

• Old HbA1c 8.0, new 7.2, down 0.8!!!!  
• Old total cholesterol 210, new 201
• Old HDL cholesterol 76, new 102 (happy cholesterol, higher = better)
• Old LDL cholesterol 117, new 76 (lousy cholesterol, lower = better)
• Old triglycerides 84, new 114

I am most pleased about my HbA1c dropping and how my HDL and LDL have changed for the better.  One significant thing is that I don't do fast food any more.  It's just nasty tasting now.  So I attribute that to playing a role in the improvement of my cholesterol.

Now it's time to focus.  Patients generally say that with the band and weight loss, it's 80% you and 20% band.  In my case, it appears to be 99% me and 1% band.  So until I can persuade my clinic to listen to me and have my band do something, it's all on my shoulders.   At least I finally feel human enough to have the desire to start taking care of myself again.

Oh, have I said today how much I adore Tina, the allergy nurse practitioner??? : )

Back to the Land of the Living

The past several months I have felt miserable.  Exhausted.  Unable to think or concentrate.  Couldn't breathe (but thought that was just a result of my chronic allergies).

I have to thank one of the nurses at the allergy clinic for taking care of me and actually believing there was a problem and addressing it.  My shot nurse Lisa suggested I go upstairs and talk to someone when I complained to her about my stuffy nose and ridiculous fatigue.  I had talked to my primary care's office in December (exercise more and maybe we should sign you up for a sleep study!) and my weight loss clinic (we'll do blood work on your iron when the Protocol says we can...that'd be February!), to no avail.

Tina at the allergy clinic is MY HERO!

I sat in the chair next to her last Wednesday morning, mouth breathing defeatedly.  She took one look and said, "Oh!  Something here is not right."

Huh?  You mean I'm not crazy?  What?

After taking a thorough history, she looked up in my snoot and the next thing I know, I'm heading to the CT scanner.  Thank GOD!  Turns out I had a raging sinus infection and that was the beast behind my exhaustion.  Who knew?  I was under the assumption that because my drainage was clear, it wasn't an infection.

But it was.  My maxillary sinuses were so blocked that nothing could get in or out.  Just sealed off festering pockets of goo.  Lovely!  No wonder I felt like crap!

She made a To Do list of aggressive therapy:  steroids, Afrin, antibiotics.  Within hours I was feeling better and after a full night's sleep, I was feeling significantly better.  I started to realize just how crummy I was feeling, once I began to improve.

I just wanted to say thanks to Tina and her expertise. It was so nice having someone who listened to me and helped me.  Unfortunately, half the time my docs just up my antidepressants when I go in with complaints.  It was refreshing to have someone validate that it wasn't in my head (even though technically it was), and that there indeed was a reason that I felt bad and yes, I really did feel bad. Not faking it.

When it feels like so many doctors just push you through assembly style, don't listen and don't even seem to care, it is so exciting to have someone step up to the plate and do what they were trained to do.

Who knows, now I might actually have the energy to exercise!  Dear Diary!

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.

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.

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?

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.

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!

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)

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!!!

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!

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.

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.

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.

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!