I find that my relationship with food still isn't as it should be.  I wonder if it will ever get completely sorted out.  I'm beginning to think it won't - and that I'll have to watch and be careful all the rest of my life.  Does that upset me?  No, not really.  Most people that live in a first world country have to watch what they eat if they choose to be healthy.  Why should I be any different?  There is nothing wrong with having to exercise some self-control - it's good for the soul I think.  I'm sure some people would think I'm trying to talk myself into this or something ...  But I'm finding myself a little stronger with this ability and that self control is assisting me in other areas. 

Recently back home from my second total knee replacement knee surgery.  It was a whole different process this time - same surgeon, same hospital - but different anesthetist and different unit doctor at short-term rehab in the hospital.  What's that mean?  Well, it means that everything was different.  I was taken off the anti-inflammatory and the lyrica on Day 5 after the surgery this time.  Which means I was left with tylenol and hydromorphone as my only pain meds.  What this meant was that I stayed on a higher level of the hydromorphone (the maximum allowed) until just a day before I was released from rehab.  Because of the nature of the hydromorphone (narcotic - morphine) they have huge limitations on what amount they send you home with.  So, I've been trying really hard to get myself off the morphine.  I walk up routinely at around 4 AM for two or three hours now, every morning.  My body seems to be wanting another hit.  I sit there and ask myself is the pain that bad, and intellectually, I know it isn't, so I don't allow myself to take the pain med.  But man, I sure want it.  This is where I find my food relationship control is really helping me out.  I never thought how it would come in handy here.  I take that knowledge of talking my way through the food desire but replace the food addiction with the narcotic "addiction".  I'm putting that narcotic "addiction" in quotes as I'm sure it's not really bad - I'm not sweating or crazy with need.  Anyhow - just really interesting how things are all connected - and I never thought it would happen that way.

I go through stages with food.  The past few months (since my first total knee replacement in November 2008), I haven't been so vigilent about protein.  I still take my supplements routinely ... but before I was very focused on trying to make sure I had at least 90+ grams of protein a day.  If I went over 100 grams I'd be very pleased with myself.  Water continues to be a struggle.  I'm lucky if I get 42 oz in per day.  I think I've only been able to get the 64 oz/day in maybe a total of 10 days since my surgery 14 months ago. 

Some days I don't eat very much - I struggle to get in 1 cup of food.  No real interest.  Other days I easily get 1 1/2 cups in at a meal and I could graze longer.  I usually tell myself to stop grazing - you're done - you're not hungry.  I still don't really ever get hungry.  I seem to have an internal need to eat - more from my head.  Not grumbly tummy that feels empty.  I have started feeling full a few times.  All of a sudden, it's just like I know if I take one more mouthful I'll explode.  I still take a long time to eat and put the plate/bowl or fork down periodically through the meal.   I don't really have a problem with no drinking around meal times.  I do confess I have forgotten a couple of times - and will take a swig of liquid 15 minutes or so after a meal.  Nothing hurts or happens - but I get nervous when I catch myself do it.

I have about 4 more months until I go for a visit to Dr Graber's office for a face-time visit.  It would be great if I was at his goal of 160 pounds.  I have about 25 pounds left to get there.  If I carry on with how things have been going over the past few months, I won't make the goal.  BUT - if I can start getting more physical, I may be able to reach the goal.  I'm just hoping my recovery from this second knee replacement surgery works out so that I can go to a gym and get some quality work-out time done soon.  Maybe in about another month or month and a half my legs will be strong enough to have a go.  That'd be so sweeeeeeet.

Today is my one year surgiversary.  

Exactly 12 months ago, I was laying in my hospital bed, feeling drowzy, and trying to remember to sip my water.  I felt fine.



Here are my results thus far:

January 1, 2003:
Weight = 425 pounds (BMI 70.7)

Consult Day in November 2007:
Weight = 316 pounds (BMI 52.6)
===> down 109 pounds     and    76.25" from 2003

Surgery Day in January 2008:
Weight = 290.2 pounds (BMI 48.3)
===> down 134.8 pounds  and   78.75" from 2003
===> down   25.8 pounds  and      2.50" from consult day

6 Month Surgiversary July 2008:
Weight = 227.8 pounds (BMI 37.9)
===> down 197.2 pounds   and   134.75" from 2003
===> down   88.2 pounds   and     58.50" from consult day
===> down   62.4 pounds   and     56.00" from surgery day

12 Month Surgiversary January 2009:
Weight = 195.2 pounds (BMI 32.5)
===> down 229.8 pounds   and   168.00" from 2003
===> down 120.8 pounds   and     91.75" from consult day
===> down   62.4 pounds   and     89.25" from surgery day
===> down   32.6 pounds   and     33.25" from 6 month surgiversay


The other day, someone posted a link on the RNY board about taking a home body fat test.  It was easy to do with my book of self-measurements in hand.   According to this test, I have 35.5% body fat - or 69 pounds of fat.  Lovely.  But still - a cool thing to know.  I should be around 22% of body fat.  Still a ways to go!
http://www.healthcentral.com/cholesterol/home-body-fat-test-2774-143.html?ic=4004


BODY IMAGE
It feels much better to be simply obese rather than super mobidly obese.  Hard to think of those days - although my body image is still as if I was super mobidly obese.  This past November, I had to be in hospital.  I cringed each time they asked me to get up on stretchers, or beds, or into chairs or wheel chairs.  They had to transport me from one hospital to another at one point, and they wanted me to get into a wheel chair.  I told them that I wouldn't fit as it wasn't a bariatric chair.  They told me to try it.  I turned scarlet, shook my head, and had a go - all ready to be horrified when my big butt and hips would get stuck on the sides of the wheel chair.  Of course all the people around me were mostly young men - my dreaded enemies all my life.  I was just about ready to cry, knowing that I wouldn't fit, when I slipped right into the chair with no problem.  I could NOT believe it.  I kept looking around, waiting for the arm to fall off or something - sure that the thing was broken and I'd collapse on the ground.  Well, it was fine.  No problem at all.  That was a real eye opener.  I find myself at least trying chairs now.  So far, none have collapsed or been too small.  I get a little more confident each time.  I wonder if we ever lose that fear?  I sure hope so.  Thinner people just don't realize all the extra baggage that fat folk carry around - beyond the obvious weight!

NUTRITION / EXERCISE / GENETICS
I was initially losing around 10 pounds a month.  That has changed to about 5 pounds a month over the past six months.  I know this is because I am eating more calories a day now.  But, as long as the scale continues going down I will be happy.  I am starting to worry a little that my weight loss window is closing ... but I can't focus on that.  If I can walk again, without a walker, I will be extremely happy. 

The weight loss surgery and the resulting weight loss has allowed me to have my knee joint replacement surgery.  My first one was on November 3/08 and my next knee is scheduled for Feb 17/09.   To have these surgeries and the rehabilitation behind me will finally allow me to go out and walk or do more physical workouts.  I trust that the pounds will continue to drop once I get more physical.  I have always thought that exercise was an important component of this journey - and have great frustration at my inability to participate in the usual cardio or key strength training routines because of my joint problems.  I was stunned to learn recently that exercise is only 20% of the impact of a person's ability to lose weight.  10% is genetics and 70% is nutrition.  !!!  Did you ever know it was that high?  I surely didn't.   

EDEMA
The impact of edema/water weight is not to be taken lightly.  I have struggled with edema in my lower limbs for the past several years.  For the first month after my WLS, I actually didn't show any real weight loss (pount four pounds - i.e. - not even a pound!) because of weight gain from the edema.  I was put on HCTZ and told to get compression hose.  After this last knee surgery, once I arrived home from the rehabilitation centre, the edema started acting up again as I was off HCTZ and couldn't wear the compression hose.  I gained about 14 pounds in around 10 days.  Once I got the ok to go back on the HCTZ and wear the hose, I've gone back down the 14 pounds.  Hopefully, this will continue.  I had hoped to show a bit more of a loss this month.  Instead, it is only coming in at under a pound.  This darn edema is so tricky.  It's hard to tell if I was really bad over Christmas and New Years or is it still the edema impacting the weight loss.  Although I did have a couple of things I shouldn't have had, it doesn't account for not going down a few more pounds this month.  Ahhh well.  I should know by next month how much more edema there is to get rid of!

BLOOD WORK
I've been very routine about my blood work.  My initial results are back on the last 6 tubes of blood taken for my 1 year anniversary.  Everything looks great - finally.  My iron levels are now in the normal range after being out of sorts for months.  My b-vitamin levels look just fine too. While in the hospital, I was having problems with potassium levels - but that was straightened out after a week or so of them monitoring and adjusting medications.

SKIN
My skin is saggy and wrinkly in most areas.  I was a pear-shaped woman - so my hips and thighs are bad - really bad.  If I am ever lucky enough to be able to afford plastics, I'm going to need a thigh lift, a fleur-de-lys, brachioplasty and some help with my breasts.  The girls aren't too, too bad - they fit in a bra fine but are so wrinkled I am embarassed to lean over.  I look down and it looks like the body of an 80+ year old woman is down there.  I am happy to be healthier - but man, that skin is sad to look at.  I wonder if they are able to use it for anything once they remove the skin.  It would be nice if it would help a burn victim or something ... but then I wonder, who on earth would want to have wrinkly, stretched skin like that?  I saw a medical show the other day.  A woman after MWL (massive wight loss) had 15 pounds of skin removed.  Gadzukes!  They had it in a bright pink garbage bag, sitting on the scale.  It was impressive. 

HAIR
I have a lot of wispy hair now that is a couple of inches long.  Kind of like an aura around my head.  I had a freak out in July or so with the hair loss.  Overall, I'd say I lost about 1/2 to 2/3 of my total hair volume.  I never took biotin as an extra supplement as I already had issues with excess body hair in places I didn't want it.  Although taking the biotin supplement would have assisted with the hair and nail growth it wasn't worth it to me if my facial hair ended up worse!  I started using the nioxin hair system (shampoo, conditioner and scalp treatment) in early August and saw an immediate lessening of the hair loss.  And I am so encouraged by all this wispy hair growth.  I look a little mussed up most of the time because of the aura .. BUT .... it's hair, and it'll grow!  YAY!

NAILS
My fingernails have been a mess the past three months or so.  The nails are soooooo soft at the ends, they rip and break with very little effort.  I'm hoping that protein deficiency I experienced after the surgery will have them rebound soon.  I'd say three months after the surgery I was getting a decent amount of protein in ... so these nails should be growing out to stronger nail bed lengths soon.


Is it worth it?  Yes. 

It's worth every jaw-droppingly good morsel I could (and do) dream about having.  

Don't make food the thing you live for.  Remember, it's nothing but crap in the end.

After my knee surgery, I couldn't use my compression stockings.  Of course, while in the hospital for 3 weeks, I really didn't need them.  I was either walking/doing physio or laying on my bed.  My ankles were nice and shapely - my legs looked long as I actually HAD ankles.  (I usually have cankles.)  I come home and over the recovery weeks - although I still have physio and knee strengthening exercises to do - I am now sitting in chairs more often.

And guess what?  My edema started coming back in full force again.  *sigh*   The scale started creeping up because of all this stupid water weight.  ARGHHHH!  I'm having deja-vu - it seems just like January 2008 - when I didn't lose any weight the first month after my WLS.  My edema was so bad back then.  My lower legs look like stuffed sausages again.  The skin is pulled tight ...

Anyhow - I've gone back on the water pills (HCTZ) and started wearing my super sexy (not) compression stockings.  My skin is freaking out every night after I take them off .... it's been breathing and free for a couple of months so strapping them back into those tight stockings are taking a toll.  I scratch, and scratch and scratch and scratch and then scratch some more.  This will pass after a while ... but man - I'm so over these stockings. 

I read on the main RNY board where another lady (Jupiter6/Shari), who has done a stupendous job of losing weight after her RNY surgery (200+ pounds!!), still has problems with edema.  Her doctors chalk it up to the weight of her pannus over the years damaging her leg circulation.  So, even though she's now down below 160 pounds, she still needs to wear her compression hosiery.  She and I sound similar - heavy "aprons" of fat, pre-surgery.  So, I'm guessing I've probably done similar damage to myself.  I was so hoping to have normal legs after all the changes.  I guess I should be thankful that they have ways to control the side-effects of the edema.  Ahhhh well.   Being fat impacts so many parts of a person - not just health and fitness - but obviously emotionally, socially ....  and I guess some things, no matter how much you try, you can never make right.  You're given one chance at this life - some parts you have opportunities for do-overs.  But some things you damage beyond repair.

Tsk-tsk on me.  That is my one regret.  I wish I had this surgery years ago.  I wonder what else would have different?

I'm just back from the hospital after having my first of two total knee replacements.  Some time over the hospital stay, I finally broke through the 200-pound barrier and I am now officially in Onederland!   FA-LA-LA-LA-LAAAAAAAAAAAAAAAAA LA-LA-LA-LAAAAAAAAAAAAAA

I had noticed that the skin on my torso and thighs was sagging more than usual, so I had high hopes that I was down.  It was a great present to come home to!!  I weighed in at 191.6 pounds .... I add about 3 or 4 pounds to get to my surgeon's scale number ..... so that is definitely under 200 now!  YAHOOOOOOO!

Here it is just over one year since my consult with Dr Graber, or 10 months since my surgery, and I'm down over 120 pounds.  I'm down over 235 from my heaviest.  Hard to believe.  So much extra skin and saggy bits.  Oh well.  Well worth it though!  I'd much rather be healthier than to have taut skin!  I have cleavage from my boobs down to my pubic area.  Looks just lovely. 


I hope to have my second knee replacement in the New Year - somewhere around February.  I CANNOT WAIT to be able to walk properly.  Life is good!  Now go out and enjoy it!!!

Hugs to you all!

Well, one week from tomorrow and I will hopefully be recuperating from my first total knee replacement surgery.  My right knee will be the first one to become bionic.  Man, I cannot wait.  I am soooooo excited.  I know there will be a lot of pain and discomfort.  Months of rehab.  But just think:  it's going to let me start on the road to actually walking again.  Wow!!  It has been so very long since I walked unaided. 

This surgery changes so many things.  It closes doors (that one wants firmly shut) and opens up all kinds of windows and doors that you never had a chance at before.  Isn't that something wonderful?  Isn't it great that you can get a chance to do a do-over at 46 years of age?  I screwed up some important years of my life by being morbidly obese.  It shut me out from doing things I wanted to do.  But I've been granted the option to do it all again.  Yes, I won't be a teenager, or in my 20's or even my 30's.  But you don't have to be those ages to experience specific things in your life.  Age is nothing but a number.  Your will and your body are the things that allow you to do things.  You have to have both working for you.  Part of my will has always been there - but my body, and the part of my will that controlled my food intake were not with the program.  WLS is now aligning my will and my body so I can do my dreams.

My husband has never known me as a thin or plump person.  We met when I was at my heaviest.  He's only known me this way.  At the time, my arthritis had not yet kicked in.  So when we shared with each other our dreams and aspirations, my looming disability was not known.  A few months after our marriage in Oct 2000, my arthritis started acting up.  By the summer of 2001 I couldn't walk without a cane.  And it progressed from there.  Instead of a being a life partner, a friend, a lover he became my assistant, my cabana boy, my chef, my personal shopper, my bather.  Nothing what we dreamed about.

As my body mass lessens, I feel a certain lightness.  I'm still troubled by the arthritis, but I feel like once these knees are done, there will be so many options for me.  I WANT TO TRAVEL.  I WANT TO SEE THINGS.  I WANT TO MEET PEOPLE.  I WANT TO VISIT.  I WANT TO SHOP AND EXPLORE.  Lots of "I want's" in there.  I worry that I'll become more selfish.  I'm going to have to watch that.

My husband worries a bit that I will change too much.  I will want to party or something - instead of doing the things we had talked about.  I don't fel a need to party. I have itchy feet - I want to see places and not to be stuck because of my body limitations.

I travelled as a youngster.  My Dad worked with the UN and CIDA - so my family travelled far and wide when I was growing up.  We lived in Ghana, Iran, Sri Lanka, Pakistan ... with many other countries visited while we were posted away in the Middle East and Asia.  These cultures are in my blood (not by birth, but by nurturing).  I want to see them, and others again. 

I   C A N ' T   W A I T   F O R   L I F E   T O   S T A R T   A G A I N !!!