1/1/06          It's a new year and this will be my year! I have gotten aggressive and motivated in the past about weight loss but never had the tool of WLS. I am embracing this tool and finally getting the weight loss edge I have never had.
I had my pre-op app't and 3 hour class on 12/27/05. During the class we got a binder of many dietary guidelines and recipes and a few sample box of Optisource products from Novartis. I have to be at the hospital at 930am on 1/17/06. My angel let me borrow some WLS books i can read when I get home from surgery. I am trying to get as many answers and supplies ready so I do not have to frantically search after surgery. I feel I am pretty calm about the upcoming surgery---but my body is sending me another message. I know this may sound strange and uncaring- but I am finding now as a pre-op close to surgery I am better off emotionally if I do not talk/read messages with fellow WLS folks so much. I am not going cold turkey but am definitely limiting my time as much as possible in this regard. I will definitely be seeking support more routinely after the surgery. It's just the anticipation can be overwhelming and I know its normal and I know others are feeeling the same way. I have to start my pre-op diet tomorrow----it essentially a low carb, reduced fat, high protein diet to shrink the liver. I am not sure what foods will agree with me best over the next few weeks given this GI distress/IBS I am experiencing. I need to get to the grocery store today to get some of these basics so they are on hand and ready to eat. I still have to get a nice steak dinner in before my surgery. Well, I am off to the kitchen to get my list started.

1/15/06 130am          Pre-Op BMI = 49.1 Well --I was so tired last night I went to bed around 8pm and wouldn't ya know it i can't sleep now - 5 hours later. The gale force winds outside along with my SO's snoring are definite contributors to my insomnia. I can't really say I have felt nervous or excited yet- and surgery is two days away. I do get a little choked up when I read about another January buddy getting back from hospital and recovering. I had a steak dinner Friday night. Had planned to go to Outback but it had a two hour wait. SO had suggested Ruth Chris but I did not want either of us to incur that expense- just for food. Going out tonight for dinner with family at a local greasy spoon. They have good fried chicken so I will probably get that given its really the only food I have ever craved consistently over the last several years. I have to be on clear liquids all day tomorrow so this will be my "last supper" for quite some time. I am looking so forward to the alleviation of GERD which I think has contributed to my slow weight gain over the years. Simply put, as long as food is in my stomach- the GERD symptoms are almost unnoticed. My SO has a cold/sinus infection with some bronchitis as the doc put his on steriods and Levaquin. I have been taking Levaquin proactively to hopefully prevent any last minute infections that may impact the surgery. It's tough though when he is sick right before my surgery. I want to be affectionate- maybe even more so than I usually tend to be - but really do not want to take the risk given I got over a slight sinus infections just a few weeks ago. I don't even want to be in the same bed with him as his infection could easily be snored in my direction. It's no one's fault really but it's horrible timing when I could really benefit from this expressive outlet. I am sure he would benefit in the same way. I am PMSing too so that may be adding to the emotions. I have to stop getting out of bed at 1-2am because these very quiet times are often when I get tearful and reflective. Not that they are bad things as we all need a release once in a while but I prefer to be busy and engaged. My cat Chloe is my nearly constant companion when I am typing on the computer. She doesn't allow me to become so self absorbed to use a box of kleenex before she starts some cute behaviors or crazy antics to distract me away from my worries. I think I have been slowly grieving the last few days especially the anticipated loss of food and eating habits. My life is much more than food but its role is something I had not realized as fully until recently. Yes- I was a proud public binge eater when I wanted to be. I had been calling it a portion control problem but it really is basic binging. I am not a closet binger and its not a one food binge. I do not believe that food was ever my best friend like I hear others say they have come to realize. If anything it has been a false friend for me. I don't want to say that food itself has had its own hidden agenda to make me ill because its not the food itself but my thinking and behavior that have really been at fault. I have not been to the Old Country Buffet (or equivalent) in sometime and I really wanted to go this weekend for my truly last visit. I know absolutely I will never return there because I feel I will never be able to eat my money's worth there ever again. (Plus they do not give bariatric discounts or have left overs/carry out). I just thought to perhaps suggest early this morning to Greg that we go there for breakfast. But- I have things here for breakfast and since we are going out for dinner tonight----its not really necessary. It may be an emotional visit for me so perhaps its best to skip it altogether. After all, I can fix an omelet here with bacon if that is really what I want. I am torn---we still might end up going just this one last time- I do love the convenience and comfort when someone else does the cooking. This will be an interesting journey finding new things to fill whatever role food has had for me over the last few decades. Exercise, shopping, sex, meditation----hum..... I know which one Greg would prefer I adopt ;-)

1/23/06          Well, I am six days post op and the discomforts are much less. The extreme gas and bloating are finally going away. I still get a lot of bowel sounds/gas moving around but its not so uncomfortable now. I still get an occasional bladder/bowel spasm but it goes away quickly. My sense to urinate is different now. I have to train myself to respond to this new feeling. My bowels are not easily moving without straining. I get mostly liquid and gas out. I get my abdominal drain out on Wednesday I believe so that will be a relief. I have cheated on my clear liquid diet just a tiny bit. I was unable to tolerate the liquid calcium citrate I have so I tried adding a tablespoon to about 1-2 ounces of Carb Countdown Skim dairy beverage and I can't even taste the calcium supplement- which is great. I took it straight and in water for two days and my stomach twisted just thinking about it as it has a bitter and sour taste alone. I must say I really enjoyed the tiny bit of dairy beverage so I am looking forward to full liquids beginning Wednesday this week.
Overall my surgery went well and the care was exceptional except for the first night with nursing staff not responding to call bell for one hour and promising to help me up to walk and failing to do so. I am not so obese I cannot walk but with two IV lines, a catheter tied to my bed, and these electronic pressure wraps on both legs - I was a prisoner in the bed unless someone helped me get out of this stuff. Early the next morning the same nurse removed my catheter in what I describe as a not so gentle way. Maybe there is no gentle way to remove those things (I have never had one before). I feel if I had separated my legs a bit- it would have been a lot less uncomfortable coming out but she would not wait a few seconds for me to do so, would not take off the confining leg wraps to allow me to separate legs and proceeded to pull it out. I can't be sure she even deflated the balloon. I also had my period - so just imagine the cramping already present. She would not wait and said she was running late and had to give report to the oncoming nurse yet- it was about 715am. My recollection was she was a militant, dictating type nurse who would not listen or consider the patient's needs. She was Asian and did not speak clear English the nurses aide was also of foreign decent and did not speak clear English either---she was much friendler but it seemed she too struggled trying to understand and collaborate with this nurse. Thank God I did not see this nurse (RN) ever again. I suspect she is in the wrong profession. I first thought she might be best suited to work with comatose patients or infants as they tend not to participate in care or want any control of their treatment. But really- I don't think that would be a good fit either as she would be less than caring and gentle with those folks and essentially get away with it. At least I was able to lodge a complaint. the issues with this nurse were probably the most traumatic part of the hospitalization and I am not sure how much the process of coming off the anesthesia compounded my anxiety and anger about it all. Nuff said of that tiny part of my surgical journey.
I am walking around the house as much as possible. Walked around the supermarket yesterday and it felt so good to get out of the house. Coughing can be quite uncomfortable for my surgical areas so I try to brace myself. Sneezing is a bit worse as far as the discomfort it causes. I am tired of sleeping in the recliner. I may have to sleep in bed tonight which I could have done sooner but for my two cats. My cats are accustomed to sleeping on the bed with me and Greg and they routinely hop on my stomach like its a trampoline to the other side of the bed... So- I will probably have to shut them out of the bedroom which I am sure will create much whining and crying on their part. Greg said he will sleep in the recliner in the living room so maybe that will quiet them down some.
I have been using a two pound weight to do some upper body exercises. My bicep muscles are still a bit sore---I believe its from the prolonged arm strapping and weight on arms during the surgery. I look forward to more types of exercise once the five pound weight lifting restriction is gone. I am getting about 60-70 ounces of fluid in per day but anything with neutrasweet is not tolerated by my stomach. So Crystal Light, SF bottle pack mixes, Jello brand SF gelatin---all are off limits now. Luckily the protein powders I liked pre-op and ordered big containers of are free of neutrasweet. I might try chicken broth again today but the thought of it was a bit sickening since surgery. I have found occasional chewing of some regular foods but spitting them out is very useful in fulfilling my need to chew and experience various textures in my mouth. Well, I gotta go make some hot tea...

2/2/06           Weight this morning = 257. I can't tolerate much food or liquid these days. I have taken a liking to shaved ice but its so cold outside and i am freezing all the time anyway- its rally not the season for a love affair with ice!?! For a few days, the pre-mixed Crystal light rasp Ice drink is tolerable but I must take the smallest sips and only every few minutes so it doesn't make me nauseous. I can usually get down 3-4 ounces of a liquid over 30-60 minutes but then have to switch as I can no longer tolerate the taste of it. I can't imagine how iIam going to survive going back to work on 2/13/06. Hopefully my symptoms and issues will lessen significantly by then. I feel like all I do all day is force liquids and liquid foods on myself and yet the total intake is only between 30-40 ounces fluid. It's exausting and frustrating when I am putting the effort into this but the results are far from optimal. I have to start exercising beyond walking- which may help me feel better too.

3/11/06          Well, I am about 7 weeks out and have been suffering with nausea and multiple food and beverage intolerances since the surgery. Recently found out my potassium was low- been on daily rx for it- for about 2 weeks and the nausea is almost gone and some of the intolerances are too! I have lost a little over 50 pounds (from my official surgeon's pre-op weight). I am still not taking in any protein powders/shakes due to extreme lactose intolerance. I am fearful of trying anything with lactose in it- but I have been able to tolerte small amounts of cheese lately. I plan to try a bit of carb countdown milk latr this weekend- that way- if I am home and have a negative reaction- it will be OK. The last thing i want to do is try something experimentally at work or away from home. I am beginning to feel "well" now for the last week to ten days. I still flt sick or ill several weeks out of surgery. I am gaining more energy now and feel my endurance for physical activity has improved. I still have this weirdly sensitive gag reflex- especially when brushing my teeth. Nausea is usually confined tot he morning when i have post nasal drip accumulation in my throat and have to try to get it up so i can breathe freely and not feel that lump of gunk in there. I have not counted calories, carbs or anything else formally (ie in writing) for about a month now. I got tired of writing it all down. I am getting in perhaps 1 1/2 to 2 ounces of 'protein" in during 2-3 meas a day. I cannot get in 3 ounces of a solid food very well yet but liquids are OK with largr quantities. I plan to get a food scale at walmart so I can have a better idea of the ounces of protein I do take in (I had been guestimating based on the paskage size or the plastic container size i put it in. I seem not to be able to tlerate lucheon meat turkey and some hams but regualr ham steak, chicken, beef, corned beef, some fish i can tolerate well. i had some low carb dreamfields pasta (probably 4 spaghetti noodles cooked) with margarine and that went doen fine. i tned to eat lots of nuts either as a lucnch meal or in between meals. My dietician told me since I am not geting in a full 3 ounces of food with a meal its OK to have small snacks in between meals now. This may change once i can tolerate more food at a meal. Some things stills taste funny/unappealing to me (due to ketosis I am told). My sense of smell is still super sensitive. I absolutely hate the smell and taste of onions currently. Regualr V8 juice tastes sweet to me 9instead of salty). Had some popcorn last night but it really needed more butter to be good. i probably had about `15 full pieces but stopped as it needed more butter to be good plus I didn't want to choke or have it get stuck like i have heard other experience. I can't manage many vegetables yet other than pottoes and carrots. I have had some homemade veg soups that I could eat the corn and peas etc. Lettuce is still and issue for me so if I eat any of it - it will be 3-4 small pieces of lettuce with a small pice of tomato with skin removed with a bit of dressing on it. I do not follow a low fat diet currently. I really enjoyed eating canned corned beef all last week for lunch 9and sometimes breakfast). I do not find I dump on the fat like the dietician said might happen. Plus the surgeon told me to add more fat into the diet since i was having some weird rash a few weeks ago. It went away- not sure what from. My skin is dry in certain areas- lately my calves are really flaky. A coworker gave me a bottle of Complex 15 body lotion and it works well and is non-greasy. Whish i knew about that lotion years ago but glad to know it now. I have resisted going out to buy clothing- as my closet has sizes 18- 28 so I can still use most of what I have. I wear most of the 18/20 pants now and 2x shirts so after another 20 pounds or so loss I will probably have to get more tops and probably some smaller pants. It depends on the manufacturer though as I know some 18/20's out there are way too tiight. My 18/20 is a poly cotton pant from fashion bug- so anything forn fitting or in a tight fabric- I probably would need a 22-24. Decaf Lipton hot tea has been my primary fuid for several weeks. I have not been able to tolerate the taste of the caffeinated beverages yet. I am not sure if I dump on sugar yet- but I have probably had 10 grams in a meal or beverage once and no strong reaction from that. I cannot tolete chewing gum yet- it makes me nauseous. Sugar allcohols are not recieved well by my stomach either. I can manage a tic tac or half a piece of regular Wrigley's gum OK. Won't even try those breathe strips yet- they are way to strong for my tolerance. I found a 17 piece "Cyclone" machine on clearance at walmart for $14.00- just like the magic bullet- I make smoothies daily and add the liquid calcium citrate to it and its easy to get down. Use bananas and strawberries usually in the smoothies. I haven't had fried chicken yet with western fries. I don't seem to crave it much now but still wonder if i can tolerate some. Same goes with a good pizza from Pizza Johns with pepperoni and mushrooms. I would love to be able to eat the topping off of one piece- but not sure I could get all that in my stomach. If I eat no more than 2 ounces at a sitting- I have not needed to vomit. Its when it approaches or goes over 3 is when I get the non-stop belching and clogged nose tht is only relieved by vomiting. I have vomited about 4 times since the surgery and all of that when in the solid food stage. I am looking forward to a Texas vacation in June. The focus will not be on foods/restaurants though- which will be a switch. I will need some smaller clothes by then I am sure- and maybe (a small maybe) a bathing suit. I might look into that tighter fitting scuba like fabric in a top and shorts as an alternative to a bathing suit.

4/6/06          The nausea has been gone for about 3 weeks now. Able to tolerate cheeses and low lactose protein shakes made with water. Fatique is pretty much non-existent. Been getting in much more 30 min- 1 hour walks since the waether has been warmer. I haven't eaten hardly any meats in the past few weeks. I tend to et things more convenient as when i have "fixed dinner" I tend to have to taste it for seasoning and by the time i get the flavor right- my meal is over- I'm full before i have formally sat down for a meal... Too much cheese and little much else is causing me some intermittent constipation though. Got my 3 month follow up with the surgeon next week. I understand lots of bloodwork will be ordered then to check for deficiencies. Hopefully I don't have many as I am just in the past month able to tolearte the calcium citrate and crushed potassium pill. I don't get much variety to eat but really don't miss variety too much. I have not been keeping a written food diary and have not been measuring portions. My portions are still small though. I did get a little scale this week. I still need to exercise more- walking is good but need some variety in the exercise realm. I have had to buy some new clothes and got rid of 4 bags of "really fat clothes". I can actually fit into some XL and 1X tops depending on fabric. Pants- about an 18-22 depending on the fabric. I can actually find more that fits me now but I am in a weird situation- many 1x tops in the plus size stores are too big- so now the added challenge of having to look in the misses sizes for some tops and plus area for bottoms. Trying to keep clothing expense down by shopping at deep discount stores. Got an Easter gathering coming up soon and Greg's family or the most part have not seen me since i lost the 60+ pounds. I don't really like the attention I get from the weight loss. The validation is nice but being a showcase for weight loss is not my cup of tea. And being nicknamed by some as "Skinny mini" or "twiggy" while playful is a bit annoying.

4/22/06            Well I had my three month check up at the surgeon's office last week. Lots of blood work ordered which I had done a few days ago and am waiting for the results. I dread the idea of having to take more supplements if the tests show deficiencies. Keeping my fingers crossed. My weight loss is reportedly 7% above average so they are pleased. I am pleased too. I do a lot of walking now but really need to get a body sculpting program as part of my routine. I am getting so close to onederland---closer than I have been in at least a decade. I am finding most 14/16 size clothes at Fashion Bug fit!?! I am imagining the predictament i will be in when 14/16 is too big. I will be having to transition out of the plus size clothing areas to the misses extra large section. It's surreal just thinking this is my future. I can fit into some extra large tops now but not bottoms. I am trying not to spend much on clothes during this weight loss period so I try to buy off the clearance rack or close out/overstock stores. I bought some 18/20 size pants about 3 weeks ago and already they are almost looking too big. I have a vacation coming in June and yes I have decided I will be wearing shorts some days. Texas is hot in June so shorts are good idea. I haven't worn shorts on a vacation for probably 15 years! Even water parks and rides I am considering now. I will probably wear a spandex type short that goes close to the knee and a relaxed fit tee shirt with a fast drying sports bra underneath. I still do not like the styles I see or the looks of the bathing suit on me and the wetsuit/speedo stuff is expensive (plus it may not be comfortable to wear all day long at an amusement/water park.) It's kind of strange- but I am starting to want to accessorize my wardrobe more now. Mainly jewelry- but I can comfortable fit into an 18 inch necklace now! Some of my old jewelry is almost too big now---24 and 22 inch chains, my engagement ring is falling off. I have told Greg we need to get new "commitment rings" for each other- more of a band style. I suppose I could get my current ring resized but I really want to trade it in so to speak. He doesn't seem to be upset or offended by that request. I think he is doing OK with my weight loss. He has lost a few pounds he says. I have not gotten a sense he has increased insecurities since my weight loss but I know this can be anticipated. He hasn't really tried to sabatoge my weight loss or exercise efforts that I can tell. If he doesn't want to do some exercise like walking or bike riding and I am determined and really pumped to do it- I just do it by myself. I am fine having a partner or going solo with exercise. Having someone (or several people) at different fitness levels trying to exercise together is not always a good idea anyway. I set me own pace which is comfortable and safe for me- which may be too fast or slow for others. I am not into competitive sports or fitness and my hunch is I will probably never be. I tend to be non-competitive in nature anyway. Not sure if that is one of my "fat personality traits" or my true nature. We shall see as the weight keeps coming off...

5/20/06             A few days ago the CRNP from the surgeon's office called about recent blood work- stating my protein was low. Oddly, my most recent blood work was a BMP (primarily ordered to see my potassium levles). Well, I found out a BMP (Basic metabolic Panel) does not measure protien specifically.... So my hunch is the low protein levels were in the 3 month lab work that they never reported to me a month ago.... At this point- i do not know what labs said the protein was low but my hunch is the news was late in getting to me. Hence, I will be requiring copies of all labs/tests from this point forward- plus the ones done in the past few months----so can unravel the mystery and get the honest truth and not the abbreviated interpretation. I work in the medical arena and do not need the 6th grader mentality interpretation of the labs either. It seems the staff in the surgeon's office do not take a few seconds to review my history before assuming and then giving me the low Medical IQ talk. So- i have increased my liquid protein intake --goal of 100+ grams a day. (although was told by CRNP to consider increasing solid food proteins...which is nearly impossible at this time for me as I get too full too fast on solid proteins- plus they are more uncomfortable when they hit my stomach). Again the competency and professional skills of the surgeon's staff are again becoming questionable to me. (not to mention the honesty and timeliness about lab reports). At this point- if I prompt my PCP about what is needing to be monitored (which she readily welcomes- she allows the patient maximum input and decision making)- I would probably feel more confident that my post-op status was being managed and monitored more comprehensively. I am thinking at this point to call my PCP for lab info and ask her for new RX in 2-3 weeks for bloodwork to measure protein rather than making another appt with surgeon's staff. I'm not sure what I will do---but if this pattern continues with the surgeon's staff- I am going to file a formal complaint with the head surgeon and perhaps higher up with licensing or hosptial regulators. I suppose I am a bit of a perfectionist- but I am less able to tolerate incompetence or neglegence with my medical care. My dissatisfaction is exaccerbated by my apprehension over hair loss- which is probable with low protein levels (and my hair was thin for decades before the RNY surgery). Needless to say I may get even more ticked off with surgeon's staff if the fall out starts.
On a postive note---I am very near entering "Onederland" - less than 8 pounds away. I can hardly remember when I was under 200 pounds historicaly---maybe junior high?!? I can actually fell my collar bones and bones in my back. But---I am also suffering in bed at night as less padding (fat) on the hips and butt and i can't seem to get comfortable for a long stretch of time. I may try a mattress overlay as getting a new pricy mattress is not an option currently- plus they may not help manage the pain any better than my current mattress. Taking Tramadol (generic of Ultram) helps but I prefer not to take pain meds of any kind- so i have only taken that a few times when the pain was distracting and of early onset.
I ordered some IDS Whey Protein liquid today- looks to be about identaical with Profect vials but less expensive (and lower shipping from netrition.com). I also ordered some more samples of Whey protein isolate powders from Vitalady.com---along with some less expensive calcium citrate tablets. i tend to chew up the regular Citracal type pills- they have no taste really and are very difficult and time consuming to crush. I probably could swallow a few broken pieces but I want maximum absorption so i am crush/chewing them. I haven't been able to tolerate the taste of BA chewable calcium citrate so far.
I am starting to wonder if I will have to buy all new clothing right before my Texas vacation the last two weeks of June. It's not easy finding stuff in a hurry so I anticipate I will be a shopping fiend just before that time. I have to take some new pics and post them. Maybe this weekend- but am seeing the Davinci Code movie tonight- so it looks like Sunday.

6/11/06               I have achieved "ONEDERLAND" this past week!?!?! I can't imagine the last time I was under 200 pounds....maybe late junior high or early high school!?!?! When i look in the mirror I can see the weight loss in my profile image but when I look down at my body - my hips/abdomen still look the same as they ever did. i know that area is smaller based on clothing size reduction but it must be some eleement of dysmorphic syndrome or something. I tried the IDS Whey Liquid rotein vials/test tubes and the fruit punch flavor is very good IMO. I have to order some more. I'm looking forward to 2 weeks vacation but next week may be quite challenging trying to get everything done before the vacation. One of these days I hope to have a job where when I leave for the day- someone else is in my role so the tasks and demands do not built up continually. One can dream anyway. I am not sure any social work position has the luxury of having someone else working in the same role on the evening and night shift...
ACS Relay for life was nice last evening. It had more to it than the traditional walk-a-thon type fundraisers. I won two items on the silent auction---a hand painted wooden chest and a surreal matted photograph of a waterfall. Greg is going to try and recruit his family to be a team as part of the one of the Relays next year.
I went for an interium app't with surgeon's office last week. Although I paid a mandatory $300 fee for their aftercare program- I am not really finding the aftercare to be very comprehensive or useful. Having to take off work and venture to GBMC only to get a prescription for some bloodwork----I could get that with my PCP. I will probably just stick to the COMP program anyway since my visits there will probably get less frequent the longer I am post-op-but it does seem to be almost a waste of time.