sarah_209

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I opened my e-mail today to get the shock of my life!  My surgeon sent me an e-mail telling me he has ordered the last pre-op EKG and chest x-ray and is ready to schedule surgery.  Here's the rub...since the battle of the psychologists (last October) and my house getting robbed (December)...and my gym going out of business...and Kaiser sending me a letter referring me to an out-of-plan weight management program (which I took as a not-so-subtle notification that I was no longer in the bariatric surgery program), I have eaten my way back up the darn scale.  I have had a long interlude with my favorite snacks (a.k.a "friends").  I REALLY thought Kaiser had dropped me!  I started shaking when I saw the surgeons message.  I almost had to go throw up it made me so nervous.  I am so scared.  Good grief.  What a roller coaster ride.

Then I went to read another members post-surgery post.  She has the same surgeon.  She had all the surgery day nightmares that I was afraid of...harsh/abrasive nurses, awkwardness and fear.  Wait, wait, wait...hurry up, and wait.  Lots of pain.  Terrible reactions to food afterwards, then the return of serious hunger.  She warned that only the truly prepared dare venture here.

[sigh].  Where do I stand?  I do not know.  I guess I need to figure this out.

I think I'll sleep on it. 

 After meeting with the social worker in Union City, I immediately made a follow up appointment with Kaiser Mental Health in Stockton.  I was assigned to attend a mindful eating class.  Then I had a one one one appointment with a psychologist.  I have finally gotten word from her that she will send a report stating that I do not need more than the support group meetings.  I don't know how long it will take that information to filter through the system.  My hope of having this surgery before this Christmas is fading, now.  Oh well.  I have faith that God knows how things should go.  I will continue to be patient and take this one step at a time.  I will continue to call in my weight each 3 weeks, even though I have met my weight goal.  As I sit here, feeling a bit isolated, I can't help but begin to question, again, this big decision. 

In my last post I stated that my psych eval was scheduled for October 29th.  This was not correct, it was October 23rd, last Thursday.  I was completely honest on the questionnaire I filled out.  Given the gravity of the surgery I am contemplating and the life changes that will ensue, I owe it to myself to be honest. 

The psychologist told me that before she would approve me for surgery, she wants me to establish a regular monthly or bimonthly one-on-one session with a therapist to help me work on long-term emotional eating issues.  I was slightly disappointed at this news, as it could mean delays in surgery. 

I was not totally thrilled with this psychologist as I sensed some judgementalism about overweight people coming from her.  She seemed exasperated with WLS patients.  It left me wondering if she had ever had a real problem with food and weight.  For so many people out there who do not turn to food, the answer is simple, "Just stop eating and start exercising."  I agree that on the surface the answer is simple.  However, being a person who struggles with food issues, I know that the changes are deeper than that.

Emotional eating...I sure would like to be able to permanently overcome emotional eating.  It would be nice to be able to face an argument with my husband, or a crisis in my mother's health without turning to food.  I have been actively working on replacing the eating behavior with exercise.  I am not where I wish to be, eventually, but I have made great strides.  Honestly, it would have been nice to hear some validation for the work I have already done.  Honestly, I am skeptical of the value of talking to some 20-something, newly minted, 115 lb. therapist about sticking to my goal of exercising instead of eating.  Granted, I made this image up, but I have compiled her as a melange of other therapists I have come into contact with who really do not understand eating issues from a personal perspective.  I will jump through whatever hoops I need to, in order to get where I need to go.  I acknowledge and accept, totally, that the real work is on the inside.  I just want to spend time in a productive way.

I was thinking that it might not be how I deal with stress, but my experience of stress altogether.  Is it that some people are simply capable of never getting upset?  How do I become one of those people?  I know that I have attempted, at times in my life, to teach myself to emotionally self-regulate.  In other words, to consciously try to circumvent the process of becoming angry, frustrated, disappointed, etc.  I have found that I can temporarily do this, but that I become this very emotionally shut down, closed off person.  I become a person who has little emotion and therefore little empathy or understanding for others.  This is terrible for my job as a teacher and my life as a wife and mother.  Perhaps the answer is a middle ground?  I don't know.  Can talking to someone one-on-one help me?  I hope so.  And I hope that I find the right person to talk to.

I made my appointment with Kaiser's mental health, locally, to join the "mindful eating" class and then follow up with the doctor who specializes in eating disorders to make arrangements for follow-up visits.  My first class happens next Wednesday afternoon.  Here's hoping that this puts me on the road to the right kinds of inner changes and that this is not just one of those awful dead-end detours.

TTFN

I have been sticking to my food regimen and exercise and I am now only 2 pounds away from my surgery goal weight.  I have an appointment for my psychiatric evaluation on October 29th.  The coordinator who made the appointment for me told me that if all goes well, the normal timeline from the psych eval to surgery is about 4 - 6 weeks.  So I am looking at possibly the Thanksgiving to Christmas timeline.

It is still hard to believe that a year from now I could look and feel so much different.

Taking it step by step.

Summer is over and a new school year has begun.  Once I decided that surgery was not for me, I started eating.  I packed on another 30 pounds wallowing in hopelessness.  The day after I waved goodbye to another group of students I woke up with a renewed hope.  It was a sunny, beautiful morning and as I came downstairs to make my coffee I looked at a photograph of my grandmother on the wall.  It was as if she were there speaking to me and at that moment I knew that everything was going to be all right.  At that moment I decided that I would rejoin the waiting list for a surgery date and move forward.  I cleaned my cabinets of all the junk foods and joined Weight Watchers again.  I drove down to the local gym and began working out.

I spent the summer working out every day and the inches were coming off but the pounds have been stubborn.  I kept my focus and had faith that all my science education would not fail me.  I knew that eventually the weight would start to drop.  Slowly it did...Kaiser took me back onto the waiting list.  Now here I am...10 pounds away from my surgery goal weight.  I called Kaiser this weekend to ask them to make the psych-eval appointment for me.  I am just waiting to hear about that.  I may be able to get this done by Christmas time and that is very exciting.

It is starting to be more real to me.  I am purchasing all kinds of different low carb protein powders to sample them.  Every meal I eat I think to myself, "How will I approach this situation after surgery?"  I remind myself not to use straws, not to drink with my meal, and to chew my food thoroughly.

Till next time...

I can't believe all this time has gone by.  Another Christmas season is in the past; another calendar page turned.  I went to my appointment on November 16th, but unfortunately it gave me very cold feet.  My appointment was at 4:30 p.m. and I arrived more than 1/2 an hour early so that I could fill out all the paperwork before being seen.  The office was buzzing, the waiting room was packed and a group of us were crowded around listening to a post-op patient and asking her questions.  They were running way behind schedule, but finally well after 5:00 the nutritionist called me in.  Her first words to me were that she was running behind and that she would appreciate it if I could keep my answers to her many questions as short as possible.  This was not a good start.  Then she excused me and sent me back to the waiting room.  While the next half hour passed, I watched the office staff shut down their computers, bid one another good night and leave for home.  Then I saw my hurried nutritionist rush out with overcoat and purse in hand.  The surgical coordinator slowly called everyone else in the waiting room to the back and I continued to wait.  By 7:00 p.m., after not having seen any signs of life besides the custodian I knocked on the door to ask if I had been forgotten.  "No, we haven't forgotten you.  We're just behind schedule today."  she said.  (my appointment was 3 1/2 hours ago!)  At 7:45 p.m., I was finally invited back to meet with the surgeon.  The poor doctor had to enter all the information I had written on my intake form into the computer himself.  This drastically lessened the quality of attention he was able to give to me.  I understand the reasons why this was important (to be sure the surgeon had actually reviewed the information, personally) but it seemed so distracting to both of us.   He explained the surgery, which I already understood and he re-explained all the potential risks, which were tremendously scary.  I sat there shivering in his office even with my coat on (their heating/air conditioning system must have been malfunctioning...they could have kept raw meat safely).  I asked several questions, but at that point I was so exhausted I had forgotten a good deal of my concerns.  During our meeting, the surgeon had to take several calls from other doctors treating his patients in emergency rooms for complications.  This was both annoying, purely as an interruption, and disconcerting as a patient.  After we were finished, I still had to meet with the surgical coordinator and get a long list of instructions.  I finally left at 8:30 p.m.
Needless to say, I was uneasy about the whole thing afterwards.  I liked the surgeon; he seemed very competent and was easy to communicate with.  However, apparently this surgical group of 4 surgeons is currently treating 5,000 patients in different stages of pre- or post- surgery.  It occurred to me that immediately prior, during and after my surgery I want the people in whom I have entrusted my life not to be distracted.  I want their undivided attention on my health at those important moments.  Would I be able to get this?  Can I trust my life to this situation?
I continued going to the gym and eating according to my nutritionists instructions.  I was still struggling with getting enough water and taking my iron on the prescribed schedule.  I actually made it to within 5 pounds of my pre-surgical goal and then I hit the setback.  On top of the uneasiness I was left with, my mother had a crisis in her life that required me to drop everything and help.  This is just the kind of stress that knocks me for a loop.  Oh well.  Then came Christmas and a barrage of food and drink and out-of-routine activities and out-of-town guests, etc.  I haven't been able to get on the scale since about December 5th.  I'm afraid to find out how much I have gained back. [ugh]
Anyway, here is my plan.  I am returning to the gym on Monday, when school resumes.  At the same time I will quit sugar again and tomorrow I am calling my regular doctor to discuss getting the echocardiogram and altering my thyroid prescription as the surgeon recommended.  Also, I will join WeightWatchers, for real, this Saturday morning (another requirment for surgery).  I will be brave, get up from the floor, and begin the fight again.  I want so badly to be healthy and to have freedom of movment and freedom from chronic foot and knee pain.  I want to feel the sense of control and accomplishment that going to the gym on a regular basis gives me.  I want my pants to be loose again.  And lastly, even though I am frightened, I am not ready to totally give up on having this surgery.  Pretending that I can go it alone is nonsense; it is denial.  It will not bring me any closer to being happy with myself.

I have been making every attempt to stick to this 1,200 calorie per day regimen.  I gave up sugar and gave up caffeine.  I found that giving up the caffeine was much harder and went back to half-caf for the time being.  Halloween was difficult, as I knew it would be, and I fell off the sugar wagon for a few days.  However, I'm back where I need to be, now.  I have lost about 13 pounds so far.  I signed up with a local fitness center and I will be starting to work out there this week, come hell or high water.

I was worried that Kaiser had forgotten about me because Halloween came and went (the one month point from the orientation meeting) without a phone call.  I called them to make sure that I had not been dropped from their program and the lady told me that their appointment calendar for December had not opened, yet, but that she would definitely call me as soon as she was able to book an appointment.  A couple of days later she called.  I guess they had a cancellation next Friday (11/16) late afternoon, so I snapped up the opportunity.  I will need to get a substitute for my last class of the day, but with luck I will be meeting with the surgeon this Friday.

I still don't have any idea about the time line of events.  I will feel better after I get a chance to discuss this with them.  There are only a couple of windows of opportunity in the coming nine months when I can be out of work.  I don't have tenior, yet.  My hope is that I can plan for early June of 2008, after the school year ends.  However, if I stay on their eating plan and fitness program, I will have already lost a serious amount of weight by then.  I have to bear in mind that things may get difficult.  Maybe this surgery won't happen.  I would be so dissapointed!  I have to have faith that everything will work out.

Since September 30th I have been on this 1,200 calorie per day regimen.  Now that I our school district is on fall break it is harder than ever.  I am hungry all the time.  I attended a two-day conference this week where they kept handing out candy to all the attendees.  I stayed away from it but it was so difficult.  Then, late in the day, I grabbed my chair to pull it in to the table and I got poked by a really sharp screw that was sticking out.  Blood was running down my hand and I was scrambling to find a napkin to keep from bleeding on everyone.  No one noticed.  It was not that I wanted sympathy, but I felt invisible again.  I haven't felt that invisible for years.  I finally found a band-aid and settled in to the activity we were supposed to be doing.  I was still so irritated about it...and I was sitting in front of a pile of candy on the table.  I didn't reach for it.  I kept my self-control.  I realized at that moment how much I have been anesthetizing myself with sugar.

I had actually forgotten how invisible I felt.  I remember the first time I felt invisible as a fat person.  I was in my early 20s standing at the counter at Noah's Bagels in Palo Alto on a busy workday morning.  I had waited patiently for everyone in front of me to place their orders and I finally stepped up to the counter.  The next available employee approached the counter, looked around me, pointing to the person standing behind me and said, "Can I help you?"  I couldn't believe it.  I eventually got my toasted blueberry bagel with so much butter on it that by the time I reached the crosswalk in front of the building I worked in, the butter had saturated the paper bag and was beginning to drip on the sidewalk.  I guess butter, too, is good at soothing emotional pain.

So, without my sugar and my butter I am stuck feeling those awful emotions.  I hope Kaiser calls me back soon to schedule my one-on-one consultation.  I feel very alone right now.

On September 30, 2007, my husband and I attended a group orientation meeting at Fremont Kaiser.  I submitted my food log, health and weight loss history.  I had to guess at my weight and I was exactly right, 240.0 lbs.  I am 5' 3" tall.  One of the surgeons gave a very informative talk going over the details of all the surgeries that their group does NOT offer and why.  She said that they would do a lab-band if the patient is absolutely committed to it and cannot be convinced otherwise, but she strongly advised against it.  She highly recommended the RNY gastric bypass.

Now I have to wait to be called for a one-on-one surgical consultation.  Also, I started the 1,200 calorie/day diet and exercise program that we were advised to begin.  I have already lost 10 pounds.  Giving up sugar was emotionally very hard, but physically it has made all the difference.  I am certain there is no way I could maintain this level of calorie restriction if I were to continue eating sugar.  Sugar keeps me fatigued and hungry all the time.  I hope they call me soon, though.  I am on school break right now and it is much harder to maintain focus without the hustle of my classroom to occopy my mind.

They gave us a regimen of pre-surgery vitamins that they want us to begin taking.  I finally found (at Costco) the elemental iron that I will add to the mix.  I was already taking most of the vitamins they suggested.  The other one I need to start is daily calcium - over and above the amount in my multi-vitamin.

With the first 10 pounds already gone, I was able to wear a pair of pants that had been too tight for me two weeks ago.  That is a promising sign.  I still have so many hurdles to clear before my surgery can be scheduled, though.  I keep trying to visualize being able to get rid of those size 22 pants, then size 20, then size 18 (etc.) once and for all...forever.  I had always kept them in my closet, just in case.  And then, time and time again, I would need to pull them out every time my weight rebounded.  But now I have hope that I can pack a box for the Goodwill and let go of them to make room for new, "normal size" items.

Another milestone for me...I shared with a few of my coworkers that I am preparing for this surgery.  It came up when my boss brought in a batch of cookies that his wife made.  Usually, everyone is used to me being the first to dive in and the one to grab that last cookie at the end of the day.   I didn't want to hurt his feelings by refusing the cookies without any explanation.  It's strange that I felt that way, after all, it is still none of anyone's business.  But it felt like more of a commitment once the words were made public...once someone outside of my family and closest friends were told.

I guess all we can do is wait, walk, and hydrate.

'Till next time...

     I have struggled with my weight my whole adult life.  As a teenager, I was thin and healthy.  However, I married rather young (19) and as soon as I became pregnant with my oldest daughter the pounds started packing on and my metabolism began to change.  I have been up and down the scale since then.  I have had great success losing weight when I put my mind to it.  Years ago I was on the phen/fen program and got down to bikini weight.   But the weight came back with my second child -- and then some.  I have since lost over 50 pounds from diet and exercise three times.  Every time something triggers the start of stress-eating and once that ball gets rolling it is a very hard habit to interrupt.  I am at a new all-time high weight now, around 240.
     I have terrible pain in my feet and left knee.  I get out of breath climbing the stairs in our home and I begin to sweat while taking even the most leisurely stroll.  My range of motion is limited and it is difficult for me to be comfortable sitting or lying down.  I am constantly fatigued and irritable.  I don't know if I have sleep apnea, but I would not be surprised.  I am past the point of being sad about the way people treat me because of my weight.  I have accepted myself the way I am -- a blessing and a curse all at once.
     I do not yet have high blood pressure or diabetes, but time is no longer on my side.  I turned 40 two weeks ago.  My grandmother was diagnosed with diabetes at age 50.  
     I recently had an appointment with my doctor for an ear infection and came out of her office with a referral to the Kaiser bariatric surgery group in Fremont, California.  A couple of weeks after that, on my birthday, in fact, I received the letter that my referral for consultation has been accepted and that I am on the waiting list to be called in for further evaluation.  The letter stated that it would be 8 to 16 weeks until they could get to me, so that puts it in the September to November 2007 time frame.  Until then I am reading all I can about different bariatric surgeries, the lifestyle changes they require, and the potential complications that can occur.
     I have spent a good deal of time on this site and have found lots of information and inspiration here.  I look forward to finding a community of people here who have taken this journey and have wisdom & experience to offer.