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...
  

My Progress So Far...

So it's been almost 7 weeks since my gastric bypass.  Lots of really exciting things have happened already as a result of my surgery (aside from the issues related to my cyst), and it seems appropriate to celebrate these accomplishments.  


The initial list of medical problems that I suffered from that lead me to the Weight Management Institute was frightening.  But look!  Some improvements are already evident, and this is only the beginning.

• High blood pressure:
• I still suffer from high blood pressure, but "my numbers" seem to be improving!
• Chronic pain from osteoarthritis in my knees, ankles and low back: 
• ✔Dramatic Improvement in all areas have been noted!
• Non-insulin dependent diabetes:
•  ✔My blood sugar is consistently excellent, and I am no longer on medication for my diabetes!
• Chronic heartburn from GERD (gastro-esophageal reflux disease):
• ✔My heartburn and GERD are cured!  No more heartburn pain or need for medication since the surgery!   
• Severe sleep apnea requiring the use of a C-PAP machine at night:
• I continue to need the CPAP at this time, however as I continue to lose weight my doctor's suggest that this will likely change.
• Impaired mobility -  I was having difficulty getting around without a cane:
• I am much more comfortable walking, and already I can get around most of the time without a cane except for longer distances.
• Periodic venous stasis wounds on my legs requiring daily wound treatment and aggressive compression treatment ranging from compression hose to the use of a lymphedema pump.  
• ✔No wounds since the surgery.  Minimal episodes of swelling in my lower legs, though I do wear a less unpleasant form of compression most of the time. 

All in all this is pretty exciting news.  Today when I saw my dietician for my routine visit,  we did a body composition test showing that while I am losing both muscle and fat (which is to be expected), even with minimal exercise I'm losing a solid amount of fat.  My ultimate goal is to lose 3 pounds of fat for every 1 pound of muscle.  Today I am at 1.75 pounds of fat for every 1 pound of muscle.  This gives me a goal to work toward.


Other positive information from the session with the dietician: I can eat most things now as long as I am cautious about the food textures (apple skins, stringy veggies, dry or overcooked meats, etc.).  Of course I am eating really small amounts of food, still.  I am supplementing my diet with the same protein powder I used for the months before my surgery when I was on the "partial liquid diet".


I have lost 50.7 pounds since I started the "partial liquid diet" on 6/4/10.  I broke the 300# mark on 9/27/10.  Follow along for continued progress, and please join me in celebrating these exciting improvements in my weight loss efforts.  I admittedly have a long way to go -- but it all seems possible to me now when I consider the progress I've made so far.  


For those of you in my "fan club" who have been supporting my efforts - thank you so much!

Weird Little Things During Week 6

I want gum -- and a Coke.  And what the f--k is with the dreams about food?

This doesn't seem too deep, this topic. I'm sure that cravings and intensely vivid dreams about food are "normal" at this point in the process.  It's just a little perplexing to me that it's all happening at once!

Before I was even totally committed to the idea of getting a gastric bypass, one of the dietician made a suggestion to the group about breaking bad food habits and planning ahead.  She suggested that we use the time we had (at that I was into the program for about 2 months, but secretly wasn't completely committed to the actual surgery) to begin looking at habits like gum chewing, drinking carbonated beverages, or drinking highly caloric drinks in the form of Coke or juices.  For those of us who had virtually months to go, this didn't seem too difficult, even though  I was a gum chewer and a carbonated, high-calorie drink consumer.

Happily, luck was with me.  I was able to quit drinking Coke, juices and even carbonated items by the time I was ready for surgery.  But now, suddenly, I am faced with cravings for things I thought I'd put behind me.  None of these things are something I can enjoy again -- it's not really safe to drink carbonation, or chew gum (especially since I am a gum swallower) after surgery.  I guess these issues may continue to follow me as I accept my new lifestyle.  The learning process for this is not a straight line, clearly, but something that will take time to wholly become a part of me.  More to come on this topic I imagine....

Weight Loss Update:  I am down a total of 50.4 pounds since my Bariatric Surgeon put me on the liquid diet and initiated the requirement of a 30 pound weight loss as mandatory before I could have surgery.  I lost 27 pounds at the time we scheduled my GB surgery.

Cyst Update:  I am scheduled for another big surgery again on October 6th for the removal of my ovarian cyst.  More on this later....

A letter to my family and friends

This is a letter that I sent to my dearest family and friends.  I wanted to share it here, too, somehow as a part of the process and experience I am dealing with as I face this surgery.  It is intimate, and honest.
Hi there, my beloved family & special friends,

I thought I would send a little update and reminder that Wednesday, August 11 -- less that one measly week away -- is the very big day that I will go have my gastric bypass, and hernia repair.

Since the beginning of this current adventure, back in November 2009, I began losing weight.  Back then it was sort of informal.  No one at the clinic focused too much on numbers of pounds, or even asked how we were doing with our weight loss.  But don’t get me wrong- there was lots of talking about food, and feelings and portion sizes and food label reading. 

By June things were a little different.  On 6/4/10, Dr. H said,”You will have to lose 30 more pounds before surgery. I have lost 37 pounds total, Since Dr. H's requirement, I’ve lost 27 pounds – good enough to go forward, and enough for my “team” to be proud of my efforts.  YAY!

So, Wednesday morning, at 5:30, I’m scheduled to check in at the hospital for my 2 - 2.5 hour procedure scheduled to begin at 7:30am.  I’ll be at Good Samaritan Hospital and after a little while in Short Stay I’ll be moved to unit “6 Center,” to a specialty surgical unit for abdominal surgeries.  I have heard that I’ll be cared for by specially trained RNs who have won awards for their outstanding care on 6 Center.  I’ll have a catheter in place for luxury peeing, and a pain pump for luxury pain management. 

So there you have it!  Some might say the answer to my prayers, others might say this is something to be grateful for -- a second chance at life.  I say:  I am grateful and I do know that it’s going to be hard work, and that’s after the surgery! I’m looking forward to it!  

Much Love,

Lynn, Lynnie, La, Ba, Noe (depending)

Fortune Cookie Therapy from "The Bowl"

From The Bowl: 

• Off with the old and On with the New
• Flip side: Roll with the punches

I think I've mentioned that I see a therapist - a psychologist who I began to see in the hopes that my disability issues would become clearer.  As time went on, she began to assist me with some of the emotional, and psychological issues around my weight and my pending surgery.  At the core of it all was me beginning both to take responsibility for where I am today, and the ability to forgive myself and move on.  I suppose that as time goes on and these issues begin to make more sense and to look clearer to me, we'll revisit them.  In any case, GW has been very, very helpful to me.


One day, several months ago in my therapy, I noticed something that really caught my eye.  A bowl.  In this bowl were perhaps 100 little card stock weight papers slips in a pale yellow with phrases on them.  As I picked on up I was delighted to discover on these little 3" x ½" slips that there were two phrases, one on each side!  The phrases were sometimes credited if the author was known, but other times were not.  All had a deep therapeutic concept in them, though not always for me, I frequently recognized a thread of something worthwhile in each slip.  They were there to act as a little therapeutic fortune cookie - cosmic, randomly chosen inspiration from Dr. W's bowl to those who might partake of this form of fun "therapy."


You may have noticed that the name of this blog is “Off with the Old: My Gastric Bypass & the Lessons I've Learned From the Process”.  It's no accident that I came up with the initial part of the phrase, and also found a slip in The Bowl that said, “Off with the old and On with the New”.  I shared this with Dr. W in my last session with her, and I could tell that she was pleased that her bowl of inspiration had come to use in my therapy.  Truth be told, every slip offers me something for the day, and for that reason alone I will share them with you, faithful readers.  Sometimes I'll even try to tie into the posting a piece of the randomly chosen inspiration from The Bowl.

It's starting... "Head Hunger"

... A seductive curl of steam rising from the plate 
... Small yellow rivulets of butter dripping down the side of creamy mashed potatoes 
... Tempting and crispy browned skin on a fragrant, succulent chicken breast 
... A distant hint of something green? Spinach, green beans?  Something green...whatever.

I'm siting here, thinking about food.  Not bunny food, but "real" substantial food with butter, carbs, etc.  Hmmm....  OMG!  It's just a commercial!  I haven't even had my surgery yet!  ::sigh::

Well, they did warn me that there would be possible reactions to or experiences after weight loss surgery, including a preoccupation with food on television.  For more information about additional reactions to or experiences after having weight loss surgery, see Appendix A under the Appendices tab.


I am definitely entranced when a commercial comes on TV parading some company's delicious foods in front of me every 10 minutes.  It's not even that I feel especially deprived on the partial liquid diet they've put me on.  I am getting plenty to eat, really.  It's just a matter or having been raised in a culture that "Super Sizes" everything, and that celebrates "The late night Munchies" -- constantly!  


My husband doesn't help, either.  Big Bruiser is 6'5" and weighs about 300 pounds.  At the ripe age of 50, he can still eat like a like a teenager - 2 large bowls of cereal at noon, and after diner, 2 great big bowls of ice cream,  a handful of candy, whatever he wants, really.  The fact is, for me losing weight *is* hard.  The sacrifices, the commitment, and the focus that it takes to make the decision to change your lifestyle is significant.  But this is the first time I've been really face to face with my "head hunger," the emotional element to losing weight, and one of the reasons that so many people find weight loss so very difficult.  "Head Hunger" is the psychological part of how we feel about food, and what we think about food.  It is highly personal, and highly individualized.  For me, this preoccupation with food on television and my reaction to the images of food is like an itch that I can't scratch.  I'm really struggling to stay focused and to put all restricted foods out of my head.  I'm eating a medically supervised diet that is considered a partial liquid diet  - high protein to prepare for my GB.  HMR 70+ vanilla and chocolate pudding 4 times a day, high potassium veggies, and 1 high protein lean cuisine a day is the program for me.  Not a lot of food really.  I'd like to point out that I *was* eating a bit more than this before Dr. H. put me on the partial liquid diet.  It's a little humbling when I think bout how much more I was eating before I started a plan of any kind.  The truth is pretty clear:  you have to keep your eye on the ball the whole time while you're getting ready for surgery, and afterward.


I'm trying to stay focused.  I know that a new stomach/new plumbing will force the issue, and the "head hunger" will episodically be worse as I move through the process of understanding what makes me tick, food-wise.  Regardless I'm feeling prepared (for the moment) to fight to good fight, and move forward - despite commercials with fast food that seem to call to me.   


Next time...  Fortune Cookie Therapy

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...