On the eve of more changes!

Time for an update!  

It's been 9½ months since my gastric bypass surgery.  It has been a bumpy ride right from the start. During my RNY GB surgery they found an 11-pound benign ovarian tumor in my abdomen that really messed with me mentally.  I realize now that I allowed the tumor to be a distraction, and that lesson is very valuable to me even though I'm not certain today how I could have avoided worrying about it as much as I did.  I also had to have a small hernia repair that my bariatric surgeon said she would repair (and didn't) during my  surgery.  Having 3 surgeries in 7 months was definitely a challenge, but trying to start an exercise regimen has also been very difficult.

Mollie Linden, 2010

As of today, I've lost 87 pounds and gained 6 (a net loss of 81 pounds as of today)!  I'm no longer diabetic (my HgA1C is 4.7),  or hypertensive (my BP is normally 110/60 - 106/56), and my cholesterol levels are all exactly where they should be.  I'd really like to reach the "minus 100 pound mark" by my gastric bypass anniversary on 8/11/10.  And, as my recently departed and much loved grand-mother Mollie would say, "God willing..." I'll be successful.  Granny was wise and loving, and once told me that it didn't matter to her if I was fat or thin.  She only wished, sincerely wished,  for me to be happy.  Considering how ill I was when my journey started, I feel lucky and (finally) very happy to be where I am.  I do have to work daily to avoid falling into the trap of wishing I'd lost more weight at this point, and it can be challenging when I look at people who have lost more than me who started when I did.  But my mantra of late, is "stick to modest and attainable goals".

One thing that's halped me immensly, is a change in doctors.  I've moved my care to a really great bariatric clinic that specializes in weight loss and weight loss surgery.   My new doctor is credited with bringing gastric bypass surgery to the Pacific Northwest, and has a long and impressive list of accomplishments, training and education.  As important to me though, is having a kind, open and patient doctor to work with.  Dr. P. is not only accomplished, but caring and warm.  This is only my opinion, but as far as I'm concerned it wasn't too difficult to find a bariatric surgeon who is "good".  It was a little trickier though, to find one who is good and also caring, kind, patient and professional.

Dr. P.'s kindness and warmth were especially evident when I expressed my concerns about my 3-month long "plateau" and weight gain of 6 pounds.  I emotionally explained that my weight was stuck in between 6-pounds, and nothing I was doing seemed to make the difference.  Evidently this is common, easily explained, and not abnormal.  She said I was likely suffering from a still-slow metabolism, and that medications can help initially in speeding up the metabolism!  Before my surgery my metabolism was only operating at 64% of predicted for my height, weight and age.  She's sent me to have a bone density scan done and a metabolic study done.  And now I find myself on the eve of my first meeting with one of Dr. P.'s partners, a bariatric endocrinologist and specialist in metabolic matters for post-op weight loss patients.  Hopefully, Dr. R. will help me figure out the next step to take to move from stuck to GO!  My fingers are crossed!

More to come...
  

OMG! I Have a Surgery Date!

Finally!
So I got the call on from my clinic on Tuesday, 7/13.  Even though I've been hoping, praying, planning, worrying, anticipating, expecting, and was generally filled with angst about it; I was completely surprised and caught off guard when Dr. H's, MA said, “The insurance has given me the go-ahead to get you on the books!”  All I've though about was the surgery.  But when she called me I was completely caught off guard.  How weird is that?

OK, so I'll go to the hospital for surgery on 8/11/10.  A week before,  I have a whirlwind of other pre-procedure stuff to do: I am scheduled to have pre-op labs drawn, the pre-op class, and a final meeting with the nurse practitioner on 8/3/10.  This is the time that they will weigh me for my 'final official weigh-in (although I *could* weigh-in on 8/10/10 if need be - very reassuring news for sure).

Since my official fan club (read family, so far) is using this blog to check in on the latest news, I wanted to review the specific procedure information. According to the Medical Assistant, I'll be having a Roux-en Y Gastric Bypass (pronounced roo -en-why). 

Roux-en Y gastric bypass is a restrictive operation where a small pouch is made at the upper portion of the stomach, which can hold only 1-2 tablespoons in volume. This procedure helps you lose more weight three ways:      

•      I'll eat MUCH less or it will come back up. The food has no choice. If you can't eat a lot, you will lose weight.  Period.

•     Apparently my appetite (as well as my taste for sweet things potentially) will actually begin to change. After the procedure, most patients find that their body will not easily tolerate foods that are high in refined sugars and fats. This is called "Dumping Syndrome." Dumping Syndrome is a common side effect after gastric bypass and occurs when the contents of the stomach empties rapidly into the small intestine, especially if I eat concentrated sweets or carbohydrates. The feeling will be a combination of profuse sweating, nausea, dizziness and weakness. "Dumping" is actually a desired side effect of the surgery to discourage one from eating sweets.  Unpleasant.  Approximately 95% post-op Gastric Bypass patients suffer from Dumping Syndrome at least to a degree.      

•      You actually absorb fewer calories. Keep in mind that your body's plumbing is re-worked. After a Roux-en Y, food bypasses part of your small intestine and digestion occurs in the lower part of the small intestine. This combined with the much smaller stomach, and reduces the amount of calories your body absorbs from the food you eat.

I’d be more fascinated if I weren’t shaking in my boots.  I'm mostly reassured that my pain will be managed, and then I just have to focus of sipping, hydration, walking and staying mobile in the face of (probably) not feeling much like it.


I'm open to comments, reassurance or any other feedback (please).  

Reflections on a Difficult Time - Going off on Medical Leave

In January 2010 I went out on a medical leave.  I had the support of my doctors, my family, and even my employer.  I did have the small matter of some excessive absenteeism due my illnesses, and unfortunately this put me in a position without any guarantee that my position would be available if/when I came back.  It didn't matter because I was just too sick to keep working at that time.  My weight loss was one factor, and of course there was the matter of my fibromyalgia.


Making this change was incredibly traumatic.  I missed my sense of purpose, my work, seeing my work partners and friends every day; and despite having some short term disability coverage, a full paycheck was  also sorely missed.  I found a great deal of support and comfort in working weekly with a psychologist (thanks, GW!), as well as important time to talk about some issues related to my weight.   I continue to prepare for an eventual surgery date, filled with anticipation, trepidation, excitement, fear and hope.


Happily, my fibromyalgia is slowly improving.  I'm bothered most by incredible fatigue from time to time when I have a flare.  This does interfere with my ability to exercise consistently, but I'm making every effort to get some exercise in daily.  I feel very lucky as I recuperate, to have the opportunity to focus on my upcoming WLS (GP- RNY, I expect) to make some long needed changes in my health and welfare.


I've been on a partial liquid diet using HMR high protein powder, lots of veggies, some yummy yogurt and some great high protein Lean Cuisines for 5 weeks now.  Tomorrow I get to discuss the possibility of choosing a surgery date with my doc, the nurse practitioner and perhaps other members of my team.


My fingers are crossed...

Off With the Old

Welcome to my blog:  Off With the Old! My Gastric Bypass and the Lessons I've Learned From the Process

I started this blog at the urging of some of the members of my team, at the Legacy Health Weight Management Institute in Portland, Oregon.  I am a patient at the Weight Management Institute (WMI) Since November 2009.  Since then I have been virtually surrounded by a team of professionals assisting me in planning for success in finally achieving my weight loss goals.  I want to say that my support team doesn't just include the Physical Therapist (PT), psychologist, nurse practitioner, registered dietitian (RD), and Surgeon (MD).  I also consider my family, my Primary Care provider (PCP),  and my personal psychologist to be just as important in my quest for lifelong weight loss. 

My Story

I have been overweight for as long as I can remember.  As a child, I was "the fat one" and I struggled despite my parents desperate and sometimes dysfunctional efforts to "make me thin".  I say this with love, because despite the worry my weight caused my family, with the comments, the bribery, the begging and pleading - I know that this was because they love me.  Nevertheless, it was difficult and often painful dealing with the pressures around my weight, whether it was a few pounds or many in question.

Last Fall I decided that enough was enough. It seemed then as if it happening all at once, but in retrospect it clearly happened over a matter of months to a couple of years. I was suffering from a multitude of medical problems that made work virtually impossible, and nearly all of my complications were related to my weight.  I was suffering from:

• Hypertension (high blood pressure)
• Chronic pain from osteoarthritis in my knees, ankles and low back  
• Non-insulin dependent diabetes
• Chronic heartburn from GERD (gastro-esophageal reflux disease)  
• Severe sleep apnea requiring that I use a machine called a C-PAP at night when I slept.  This requires getting used to a face mask of sorts hat blows air into your airway to keep it open while you sleep
• Impaired mobility -  I was having difficulty getting around, and now had to use a straight or single point cane.  

I agree that this is a lot of medical trouble, but that was not the worst of it.  I also suffered from:   

• Periodic venous stasis wounds on my legs from leaking veins that were causing a need for sometimes painful daily wound treatment and aggressive compression treatment ranging from the "oh so fashionable" compression hose to mechanical pumping using a lymphedema pump.  This pump machine is recommended for use for several hours a day to control lower extremity edema (swelling).  
• And the compression hose?  They are as uncomfortable as they are ugly.  

Suddenly it seemed that I was a mess and was heading toward disability very quickly.  And that's why when I was diagnosed with Fibromyalgia, on top of all of the rest of it I knew I didn't stand a chance.  Triggered by my many medical problems, my fibromyalgia flared out of control.  I was missing a third of my scheduled work time, and I was facing issues at work due to my absenteeism.  My job was on the line for the first time in my life.  I knew then that I needed to go out on a medical leave.  Fortunately, my PCP, Dr. D agreed.


More soon...