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That's right -- I finally hit the magic "century" mark.  It is magic, right?  Certainly I have some profound wisdom to share.  Thinking...thinking...

1. How did I let myself get so obese?  When I look at my before pictures, I wonder that.  I was disconnected from who I was.  I did not see myself as THAT big, though I felt it in every way a person can.  Those 100 pounds were at least as hard to carry emotionally as they were physically. 

2. Everyone is unique, different.  Everyone will have a unique weight loss experience.  Some will lose faster, some slower.  The foods we eat vary.  If you see a break in my blog entries it is because I actually had to stop coming to OH for a while because I got into the comparison games.  It helps to share a lot of common experiences, but I have learned that we are all different people with different life experiences, strengths, etc. 

That seems to be it.  I will also sneak I am not the best at following all of the rules in regards to protein intake and water.  I do my best but don't stress about it.  There was no way I came even close to getting 70 grams of protein pre surgery.  I am guessing my post surgery protein intake is a bit higher because I am aware that protein is my friend and because my ability to eat some carbs (pasta, bread) is still pretty limited.  Luckily, my desire to eat these carb monsters is also limited.  :)  And that, my friends, is what makes the VG such a wondeful surgery.  In all honesty I can say that the main reason this surgery is working for me is because my cravings and desire to eat is greatly reduced.  The fact that I can only eat a small amount is icing on the cake...but it is cake that I don't even really want to eat. 

I've been hovering here for a couple of weeks.  I am just waiting for that one more pound to take a new set of pictures.  I have been trying to take pictures every 20 pounds or so.  Until I add my newer ones to my profile, you can see my progress at this link:  http://imageevent.com/pinkmommy/weightlosssidebysidepix

I started at 260.  I am currently at 161.  My goal weight is 135ish -- give or take a few pounds.  My original goal was 144 and it seems strange that I am so close to that goal. 

I confess I have not really exercised yet.  I know I have to get going.  I hate exercise.  I really do.  No.  Really.  I have friends who have lost gobs of weight and have been converted to exercise lovers, but I will never be there.  My goal is to at least not hate it so much.  I need to find fun things to do that I enjoy.  I am thinking of things that are competitive.  Or perhaps dancing.  Does typing count? 

It's been a while since my last update. We have moved to North Carolina. We have been here 2 1/2 weeks. We are currently living in a one room hotel. It's a good thing that I've lost some weight because I'm not sure I would actually fit into this room before...it is that small. It has been challenging having to eat out so much. On the good side, my lack of food intake saves us money on the dining out front. Being vegetarian, I have had some hard times trying to find something I CAN eat and WILL eat. Normally, I'd go for salad, pasta etc but those sort of things aren't sitting well with me. I am having veggie burgers, baked potatoes with cheese, refried beans and small amounts of pizza if I avoid eating too much of the crust. Well, everything is a small amount. I have had a few days in which eating was a struggle, but the past few days have been better. The main thing I think that is important when newly eating after WLS is to take it slow, chew the food well, and pause. Take two or three bites and then just wait to see how you feel. That may sound awful to someone from a pre-surgery point of view, but honestly I do not want more food. I am very satisfied with what I can eat. There are times when I want to eat something I can't right now (salad!), as well as wanting to eat more than I can eat, but in comparison to how I felt pre-surgery these feelings/cravings are so much smaller. I am about six weeks out from surgery. There are some things I can't eat now but may be able to eat when I am further out. I have lost 36 pounds. I haven't gone shopping for new clothes yet. I only have one pair of non stretchy pants which are very loose on me, but I can deal with them a bit long. The rest of my wardrobe consists of stretchy pants and baggy shirts. The baggy shirts are just baggier. Oh, I did buy three t-shirts that are more fitted.

Just a quick update with my weight loss. I am down 14 pounds and my BMI is now under 40! By my doctor's scale, I am down 20 pounds. That weight was from my consultation but I did lose a bit before the surgery. I have been losing about a pound a day, but some days I don't lose and than the next day two pounds come off. Today was a "no lose" day and I was really hoping to get down into the 230's, but for now I am hovering at 240. I'll update more in a bit. It is pretty crazy here, so my time is limited.

For the first eight days after surgery, my incisional pain was pretty intense. Pain meds certainly helped and the pain was never unbearable. By day five, I was only taking pain meds at night. The pain was not constant, only with certain actions such as getting up, sitting down or coughing. Aound day nine, the "movement" pain felt more like an intense ab work instead of sharp, specific pain. I am surprised about the intensity of my physical hunger, as well as my head hunger. I am only drinking clear liquids and protein shakes. At the two week mark, I can add thicker liquids to my diet. At the three week mark, I can add soft foods to my diet. At the four week mark, I can slowly start to eat "real" food. In all of these stages, my caloric intake should be 400 - 600 calories and 70 grams of protein. At day five, I started using a program to track my nutritional intake and was surprised that my total calories for the day was 294 calories/34 grams of protein. Yikes! The next day I was much more careful and since then I have hit my min level of calories and protein. I am hoping the head hunger is a result of not being able to eat food. Right now, everything sounds so good. I don't want to be MORE obsessed with food, but I feel that is almost the case. I know if I were merely on a diet, I would have cheated by now. What keeps me walking the line is the idea of creating post surgery problems from eating too soon. I have lost 9 pounds from my pre-op weight. I have lost 17 pounds from my two day post-op weight which was higher than my normal weight because of IV fluids. Perhaps when I lose enough weight, I won't feel the need to chime in with the fact that I gained 8 pounds post surgery from IV fluids. :)

Perhaps you'll want to grab a cuppa tea because I want to relate my surgery experience and it could be lengthy. I will start with the day before my surgery. I had my first a-ha moment in my discovery of how food plays a role in my life beyond just filling up my stomach/physical hunger. I woke up on Sunday, the day before my surgery and was going to pop out of bed and have decaf coffee and toast with Nutella. There is nothing that says good morning to me like Nutella. I started fumbling my way out of bed and realized that I could not eat anything on my pre-op day. Bummer. I was no longer so eager to get out of bed. That is when it hit me at how much food can be a motivator to me. After I do this, I will get that where this equals something equivalent to getting out of bed or paying bills and that equals anything chocolate (except for protein shakes). In truth, that could be a whole lot of things. My next a-ha moment came as we were packing and preparing to drive from our town to San Francisco (40 miles away). My kids were eating popcorn and my two year old came over to me and said, Here, mama! Popcorn!  I took his proffered snack and almost put it in my mouth. As it touched my lips, I realized that I was not supposed to be eating food. Mindless eating was a second encounter with the truth of how food plays a role in my life. Two revelations and I had not even had the surgery! We stopped at the mall in San Rafael on the way to San Francisco. I actually had to have my wedding and engagement rings cut off! How awful is that!? I had been trying to get them off for some weeks. Many web sites offering help in this realm (yeah, apparently I'm not the lone offender in wearing too tight rings) suggested Windex. I'm not sure if a few too many people have seen "My Big Fat Greek Wedding" or if there is actually some truth to the Windex assistance of tight ring removal, but it didn't work for me. I tried various lotions, dental floss and a lot of twisting motions. No go. The first jewelry store with which I checked considered it an odd request. They had no experience with cutting off rings. They did not have an actual jeweler on site, but a saleswoman there did take out a scary looking tool and held it up to my hand to see if she might figure out how to use it. I declined her shaky offer to try to help. Luckily, there were other choices and my next stop yielded a person who had experience with this sort of thing. The man had a special tool with a guard. The guard protects your finger and then he saws off the ring. I did experience some discomfort/pain, but all in all it was not too bad. It was worse emotionally: I had to have my precious rings cut off because my fingers were too fat. No glamour there! After we checked into our hotel, we went to Ghirardelli Square. Yeah, that was a bit hard with the whole not eating thing. It is against the natural laws of this earth for me to be at Ghirardelli Square and not eat chocolate, but I will confess I sipped some cocoa. That counts as thin liquid, right? Rich and the kids ate dinner at a pub and it was pretty challenging to just watch. Back at the hotel, we all got ready for bed. I took a long hot bath to help me relax. I did not sleep well at all. The bed was very uncomfortable. The idea of having surgery was even more uncomfortable. I suddenly had thoughts about showing up at the hospital but all of my files being lost. I had two alarms set for 4:50 am (early rising is another issue that defies my natural laws) to be sure I didn't oversleep. As it was, I was awake and didn't even need an alarm to wake up. I got up earlier and turned off the alarms. Rich and I had decided that I would drive the truck to the hospital. I didn't see much point in waking the kids up and everything. The hotel offers a free shuttle service to the hospital, but the shuttle is not available until 8 am. I could drive the truck and not have to pay or wait for a taxi and my family could take the shuttle a bit later. Rich woke to see me off. It was a sad moment for us. I know he wanted to be with me, but we had to do what was best for all of us. In the parking garage, I had to wait for 10 minutes because the parking attendant was not at the gate. I phoned to inquire and he was using the restroom. "Can you send someone soon?" I said, "I have to go to the hospital."  Ha! I could finally use that line. At the hospital I parked and walked up a very steep hill only to discover I was at the wrong building of the hospital. I needed to be at the Stanford Building instead of the main building. It happened to be right close by and a postman making rounds pointed me in the right direction. In the waiting room, I was given one form to fill out. The form was contact info so the doctor and nurses would know where my husband was to let him know the outcome of the surgery. A few minutes later, I was taken to a nurse's station by an assistant who looked and acted like Bailey from Grey's Anatomy. I changed into a robe and then a nurse came to put in the IV line and take my stats. After that, I moved pretty quickly to sort of a pre-op area sectioned off by curtains. There was a very nice nurse there who greeted me and told me she had bariatric surgery 2½ years ago. She was upbeat and positive, giving me encouragement for my surgery. I waited there about 10 minutes before the anesthesiologist arrived. During those 10 minutes, I sort of had my "cry baby" moment where I felt scared and lonely. I just prayed for peace and did feel a lot better. The anesthesiologist's name was Dr. Yoon and he was very kind, gentle. I could hear some of the going-on's from the other patients. It was weird, surreal. Dr. Jossart came in for a quick discussion and then things got moving pretty fast. The OR nurse, Pam, arrived to take me to the OR. She had a British accent. Funny -- the small things you remember. Nurse Pam walked me to the OR room. I had never been in an OR room and it did not look like I imagined it would. It kind of looked like a lab. There was another nurse there but he was busy preparing things for surgery. Once I was situated on the table, Dr. Yoon said I would start to feel great in about 30 seconds. Next thing I know, I was waking up in the recovery area and a nurse was nearby telling me my surgery was over and it went just fine. I remember feeling confused and nauseous, but I wanted to become alert quickly so I could see my husband and kids. Another attendant came to take me to my room. I remember him being very nice and funny, putting me at ease along the way. I had a great room which seemed more like a hotel room than a hospital room. I was anxious to see my family and was worried they didn't know where I was, but after a short time in my room, they arrived bearing a plant with pink flowers. My kids were just soaking up the whole hospital thing. I think it was overwhelming to them. They arrived just at the time I was getting ready to take my first walk around the ward, so they waited patiently for me to finish my lap around. That was about 11 am. I had a short visit with my family. The rest of the day and evening, I alternated between dozing and then waking to go for a walk and use the loo. I never had a catheter in me and was pretty glad for that. I had this oxygen tube in my nostrils but it was loose and unconfining -- easy to get on and off. I had the compression stockings on which felt good to me, kind of like getting a massage. I had a few ice chips but felt quite nauseous so I didn't push it. I remember feeling thirsty and my lips were dry. I was glad I heeded the advice of many to bring chapstick. I watched some TV in the evening. My friend, Tami, called in the evening which was a surprise because I didn't know how she knew the number and I remember tripping about that for a while after our conversation. Perhaps around 9 pm, the nurse came it to check my stats and let me have another walk around and then I dozed to sleep until 3 am. When the nurse came it to check my stats at that time, I asked if I could walk around and she said yeah and that was my first solo trip around because my chart said I was ready to walk solo. That time was very special to me. I had a quiet walk around and stopped to look at the city views at some of the windows. I had a lovely view from my room and just enjoyed the serenity of the nighttime. It was back to bed for me and I woke again about 7 am. I actually had quite a restful night in the hospital. My room was dark and quiet. The medication helped me relax and sleep. In the mid morning, the nurse took out my IV. I was then able get up and walk whenever I wanted. I tried some veggie broth around noon and did my best to swallow whatever melted ice chips or water I could. The nurses were monitoring my "output," so I wanted to have enough output to be able to be discharged that day. I had blood work taken during the mid morning to check some of my cell counts, etc and a visit from the hospital social worker. I think it was about 3 pm that I was discharged to go home. My husband pulled up t our truck to the loading area and my kids stayed with me. My daughter didn't want to walk, so the attendant let her sit on my lap as he wheeled me down to the lobby. My daughter thought that was just IT. I have been home for four days now. The nausea subsided within the first day. My incisions are a bit painful, but my pain medication is effective. I have learned how to move slowly. Getting out of bed takes a bit more time, but I have this technique where I sort drop my feet to the floor and let gravity help me up. Holding a pillow to my stomach has helped when I sit down or stand up. I was taking four doses of pain meds a day, but I am down to two. I am on a clear liquid diet for two weeks, but that includes protein shakes made from nonfat or 1% milk. Taking frequent slow sips has been a learning experience. Now that I am up and about more fetching snacks and meals for my kids, I am starting to think various foods sound good. My appetite is returning. However, a few ounces of a protein shake, tea, water or veggie broth seems to satisfy me for a long time. Perhaps at any other time I might almost enjoy this opportunity to doze more than usual and recover, but with a cross country move coming up in a few weeks, I keep telling my body to hurry up and recover. I have boxes to pack, meals to make and places to go!

My surgery is three days away. *gulp* I know many have waited a long time for their surgeries, but everything has gone so quickly for me. From initial interest to surgery it was three months. I worked my way through the various pre-op requirements. It helped having the sleep study and psych evaluation done so early. The sleep study was done before I was even considering WLS. My doctor wanted me to wait until two weeks prior to surgery to have the blood work. Last night, I completed all of the consent forms and it was more lengthy than I anticipated. I think I signed over the name of my next child to the surgeon, or something like that. I have received an official approval letter from my insurance company. I was fortunate that my insurance company approved me very easily. Not only did they approve me for WLS, the also approved the gap request so that they will cover at 100% instead of the 80% of usual since it is out of network. The argument that LapSF made for the gap request was that there were no in network providers for me to use. We are tentatively set to move to NC about 4/22. It is just absolutely crazy around our house right now. I have been in prayer about all of this so much. It is hard not to pray for ME ME ME right now. I want my prayers to be in line with God's will for my life. I know God wants to bless me. I keep trying to focus on real, lasting blessings. I somehow feel a little guilty that I may have a healthier body that I feel better about AND a nice home when we move to NC. I think of all of the people in this world who are hurt and suffering. I think of people who are lost. I feel almost a bit guilty for having so much hope in my future. My real hope is not in the body I have or the house in which I will live, but in who I am in relationship to God. I keep praying that God guides me in how He wants to use the blessings He gives me. In regards to the idea of facing surgery in a few days, I will be honest and say I am nervous. I don't particularly care for hospitals, so that aspect of this whole process is definitely not something to which I am looking forward. I know that the hospital time and even the recovery time are short in the great scheme of things. From a statistical point of view, I have a .2% chance of dying from the VSG surgery. My own doctor�s statistics are better than that (not that that stat is all that bad when you consider the statistical chance of dying during any surgery is there -- 1.8% chance of dying during an appendectomy, for example). I am not particularly afraid of dying. Ok, maybe I am afraid of the pain. Everyone dies and the real question is will I be with my Lord in a few days or in a few decades. My deeper anxiety is leaving behind my children. I admit to some vanity in that I want my children to know who I am. More than that, I want to be a part of their lives and help guide them. I want them to grow up in a loving, Christian home with parents/caretakers who give conscience thought to choices and actions. My husband is thankfully on the same page as I am about raising our children. This will probably be my last post until after the surgery. It is strange to think that the next time I post, I will be physically a different person. I know it will take longer to get their emotionally. I will be learning to eat in a different way instead of eating just because I can and often because I *want* something -- where often that something is more than food. I will have to find new ways of dealing with stress. What a time to be doing that! I will have to find new ways of rewarding myself. I will have to find new ways for old habits (i.e. eating whilst watching TV).

I had my consultation with Dr. Jossart on Friday, 2/17/06. For some reason, I was so nervous before my appointment. The appointment went just about exactly as I had hoped and expected. Dr. Jossart started reviewing the various surgery options, but I let him know that I had already attended the orientation and received the exact chart he was reviewing, as well as having read a lot of information about various options. Then I launched into my specific questions about the VG. I am confident Dr. Jossart is well researched and experienced in the field of weight loss surgery. I did not feel any pressure to have or not have any of the surgeries, but he did say the VG or the RNY would be my best two options in his opinion. The advantages of the VG are that it has less problems overall (i.e. bowel obstruction, ulcers) yet it is an effective surgery for my BMI. The percentage of excess weight lost with LapSF patients for the RNY is 85% and for the VG is 84%, so they are comparable in regards to weight loss. I do believe with the VG I will have to work harder to maintain my weight loss. Dr. Jossart reminded me that with any of the surgeries, it is possible to gain some or all of the weight back. He provided me with the names and contacts for people at LapSF who can help me get going with surgery approval and a date, even suggesting that I go ahead and schedule the surgery date because I have some of the tests out of the way and an insurance company that is generally easy to work with in regards to WLS. I spoke with the dietician the same day and that required component was completed. I will also be having my gallbladder removed during the surgery. Though I would ideally prefer to keep my gallbladder, the fact that I have already had gallbladder problems combined with my insides already opened (for WLS) as fair game does help me come to terms with having it removed. I am waiting on returned phone calls for insurance issues and surgery scheduling. I also have to move forward with some lab tests and get into my OB/GYN for an updated exam (fun, fun). I am hoping that the next time I update, I will at least have the surgery date and at most have the insurance approval. *********************************************** 03/03/06 I am trying to do what one post-op person suggested and really use this time to reflect on my thoughts and feelings. It has been chaotic though because WLS is not the only huge life change coming my way. More on that later. Regarding WLS, I DO have a surgery date. I can't believe it has taken me over a week to post this. My surgery date is 03/27/06! Up until yesterday, I was apprehensive about being able to complete everything I need to do before surgery. Yesterday, things seemed to fall into place better. I have to be up to date on my Pap test. I have an OB/GYN appt on Mon to get that done. That has actually been the most difficult because I've scheduled several appointments but my cycle has been irregular so I have had to cancel the appointments because of poor timing. I spoke with my PCP and she is ordering all of the tests I need to do. I will have an EKG at PCP office. If there are any concerns based on that, she will go ahead and do a cardio stress test. My PCP also has a chest x-ray referral for me to pick up. I don't have to have an upper GI. I have already completed the sleep study and psych evaluation. Things are moving along. On the insurance front, Marilyn from LapSF applied for insurance approval. She also requested a "gap," which is some request for the insurance to pay surgeon at 100% instead of the out of network 80%, as there are no in network doctors. I am waiting for both the results of the insurance approval and gap. If nothing else, going forth with WLS helps one to cultivate patience (or not!). I will have to pay the surgeon fees upfront and then the insurance will reimburse us. We will probably use a low interest credit card for that process. I ordered a sample pack of various protein concoctions and am starting to make my way through those to get an idea of what I might like. I have heard people say your tastes change after sugary, so I am not sure how on target I will be with deciding upon protein shake choices. I have told a few people about WLS including a couple of close friends and my mom. So far, the response has been pretty positive. I have a lot of information floating around in my head and can easily overwhelm a person with facts, stats, etc, so I am trying to come up with a short version of what the surgery is and why I have chosen this path. The other big change coming forth in my life is the fact that we are likely moving from California to North Carolina. My husband will stay with the same company, but he has an opportunity to work in a different area, with a different group. The "difference" likely means something more suited for him. Perhaps the biggest benefit of all of this is the cost of living factor. Especially in the area of housing, we will get a lot more bang for our buck. Still, it is a major life change. We do not have any family nearby. Our closest family is 300 miles away. It is a consideration that we will be moving out of state from my family, but then it doesn't generally make a whole lot of difference whether we are riding in a car for 6 hours or flying on a plane for 6 hours. Ok, so flying is more expensive, but if we are not paying the huge mortgage costs that we are here, it is also more within our budget. Leaving friends will be a challenge. Leaving many established things here such as church, our gym, school, etc will all be sad and difficult. I feel as if I have a positive outlook and look forward to making new connections in North Carolina. I lived in Georgia for three years, so I have tasted Southern culture. The particular area of NC in which we will be living is somewhat of a twist on the South, as it has a bit more varied influences.

I hate just waiting for a consultation. I want to DO something. The more I read and think, the more I am going in the direction of WLS. I also need to be on my knees in prayer about this. Today I called United Healthcare PPO to ask about coverage for WLS. I already know from the information received by LapSF that the type of surgery I am wanting is generally covered by UHC. The representative verified that WLS is covered. She said it is covered at 100% in network and 80% out of network. I am pretty sure this will be an out of network thing but I may be able to appeal for 100% coverage based on not having any WLS doctors inside my area. The representative said I don't need any referral or preauthorization for my consultation. I also asked about mental health services coverage for my psych evaluation and she said it covered at 100% in network. Woohoo! Before I started writing this, I called and left a message for a doctor on the list for psych referrals. He is on both Dr. Jossart's list as a recommendation and my insurance list as a provider. He called me back just now and we scheduled an appointment for 4 PM tomorrow. He sounded very knowledgeable about doing them and also very nice. He said he is quick to get them done, too! I feel as if I am making progress in the direction I am trying to go. Still, I am prayerfully seeking God's will in this matter. Doors do seem to be opening!

Why can't I stay motivated? Why can't I make the healthy changes I need to make? I am trying to figure all of that out. From the one time I did succeed in losing a lot of weight, I truly think the first part of making positive changes is a mental/emotional thing. I know that after my first baby was born, I was about a size 18. I weighed 180 pounds. I felt SO huge. I think I gave up then and told myself I was a fat person -- and acted like a fat person. In regards to my health, I felt lucky to have escaped many of the problems that often go along with obesity. However, more recently I am having some wake up calls. I was recently diagnosed with moderate sleep apnea. I am using a c-pap machine. Sleep apnea is a serious condition impacting heart and lung function, energy levels and many other areas. I also have very high cardio c-reactive protein (above 10). C-reactive protein is sort of a newish lab test that many doctors are starting to use because there is often a higher connection between elevated c-reactive protein and heart disease than elevated cholesterol and heart disease. Half of all people who have heart attacks have normal cholesterol. Anything above a "3" is considered high for c-reactive protein. Anything above 10 makes the doctors look into more serious health issues, such as cancer, auto immune disease, etc. My cholesterol and blood pressure are fine, but I do have to take Crestor in an attempt to lower my c-reactive protein. The first re-test showed that the Crestor has not lowered my c-reactive protein. I am going to take the Berkeley Heart Lab test and my doctor is hopeful that will give some insight as to why my c-reactive protein is so high. I also face the usual struggles of lugging around 100+ extra pounds. I can tell you it is not easy keeping up with my little ones when I am such a big one! I have been trying to make some good changes. We joined a gym and are going once a week, sometimes twice a week. I know I need to up the frequency and have scheduled that at the beginning of January, but as January is drawing to a close I have been dealing with illness quite a bit - just the usual cold and flu stuff that has been making its way around my family. I am scheduled for a mid February consultation with Dr. Jossart. I am looking at the VG. I know that the malaborption issue with the RNY is a real concern for me. I am going into the consultation with an open mind though.