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 I feel it necessary of me to mention that Dr. Laker was NOT my original surgeon. The fistula has absolutely nothing to do with him. I was planning on having a revision with him before my insurance lapsed, and I still haven't gotten around to/can't figure out how to change/hide the surgeon info on my profile. 

I think Dr. Laker's a really swell guy and I'm sure he's an excellent surgeon. :)

 Still no revision. But I've been doing a lot of talking, studying, etc.

Did you know that there was a study done that linked the occurrence of Gastrogastric Fistulae, (my condition), to poor surgical technique? OUTDATED surgical technique, at that? I was shocked when I found that study. But, I have to admit, I also found myself quite satisfied. 

Justified.

Vindicated.

Vindicated is the perfect word. Because for two years I had been walking around thinking that I did this to myself, that I caused this and that I was the reason that this was all failing and going to shit. Not so... NOT so. I am so pleased by that. So very, very pleased.

Still. In the long-run, it still leaves my little tummy broken and in need of repair. A Gastrogastric Fistula is basically a hole. Think of it in the scientific terms. In science, a "fistula" is similar to a "rivulet". A little breakthrough of water from one barricaded section to the next. That's what's happening here. A breakthrough. Or rather, a breakDOWN. Of my staple line, if I've read correctly. So it's kind of like a hole which provides access FROM my created pouch into my old stomach. 

This comes with a variety of consequences. A sheer smorgasboard. Acid reflux EVERY night. (Which we know, extended acid reflux activity can, long-term, lead to cancer), the possibility of internal bleeding and ulcers and regain because I don't maintain feelings of satiety... phrases all of us post-ops know ALL too well. I'm susceptible to all of these things. And, I will not continue to lose weight, really, until a revisional surgery is performed.

Know what sucks about that? I'm one of the millions of uninsured Americans. So, as we know, no such thing as a surgery is going to be performed on this little girl. That's frustrating as HELL. I don't know what to do with myself right now. I don't know what practical steps I can take to take care of myself RIGHT NOW. I do not have the money for proteins and all of this other stuff. That's just reality. I'm unemployed, uninsured... and I know I'm not alone in that. I used to think I was, but now I know better.

Thing is, I don't WANT to wallow. I want to FIGHT. I just have no idea how to. 

Nope. I'm not dead. Quite alive, actually. I've just been staying away from the "community" for a long while because I see a lot of things wrong with it. A lot of expectations that seem a bit ridiculous to me and people willing to make fast assumptions about other people when they're surgical journeys don't go down to the letter of perfection. That's not what mine has been, and I KNOW it's the same for a lot of other people, so I've been steering clear.

My old blogs make me laugh. I was such a ridiculous drama queen. I was one hurting little girl, too. So lost and frightened. It makes me wonder at how I still struggle with the idea of perfection and demanding it from myself and feeling as though others are demanding it of me even when they've done nothing to make me assume such a thing. I think when we demand something of ourselves we tend to project that out on to other people. So I am constantly demanding perfection of myself and others, and I assume everyone is that way, too.

I've done a lot of growing up in the time that I've been away. In fact, tomorrow is my twenty-first birthday. This April (April 3rd), it will be four years since my surgery. I really can't believe it, to be honest. To look at my life then and to look at my life now. I am not the same girl. Not by a longshot. This road has been hard and filled with trials. I STILL have a broken tummy, (never did get that revision). But I'm still looking to change that. And learning how to live life with a little less drama, a little more of an easygoing attitude, and a little less expectation of perfection.

In fact, nowadays, I embrace my imperfection. I love being sarcastic and snarky because no one is perfect and those who purport the idea that they ARE... are the most ridiculous ones of us all. I don't always drink protein, (in fact, I quite dislike protein shakes), I can't really afford vitamins so I do my best with what I have, and I think that whole, "You're WORTH the expense" line is bullshit. I might be worth the expense, but is my family's home worth the expense? Methinks not so much.

Anyway, I'm still deciding if I'm gonna hang around. We'll see. :)

I'm having so much trouble lately. Since I've been diagnosed with my ED, it's all I ever think about. It consumes my thoughts and my time. I don't go through with a lot of the behaviors anymore, but it still consumes me. Every time I eat, I want to purge. Every time food is put in front of me, the voice in my head counts the calories and tells me how fat it's going to make me and that I'll never be thin and beautiful. It beats me down all the time, and I just can't take it anymore. I'm so sick of it.

I've been in therapy on and off since I can remember, even since my surgery. It never seems to work. But I guess I just have to deal with it. Maybe this is the hand I was supposed to be dealt. Maybe I'm destined to end up a failure... destined for inpatient or even worse... destined for death.

I'm slipping away again and that terrifies me. Absolutely terrifies me. But I can't reach out for help. My ED won't let me do that. There's a thrill in the secrecy and the lying. There's a personal joy in being "stronger" than I once was. Not that I really am, but I fool myself into thinking that I'm stronger than everyone else when I don't eat or when I purge.

Well... no, I take that back. When I eat and then I purge, I feel like the ultimate failure. I feel disgusting, worthless, unlovable. It's when I refuse food that I feel strong and thin and amazing. Purging helps the physical and some of the mental, but not all of it.

See? See how screwed up I am?

It's been awhile. So here I am, getting closer and closer to my two-year surgiversary, and I'm just now learning about the ways positive thinking can impact this journey. I found out about a week ago that my staple line has broken down, and I've been in tremendous pain because of it. I don't blame it on Dr. Frantzides, I blame it on myself for being foolish and childish.

Anyway, I'll most likely have to have a Revision. While that's not thrilling to think about, if it's necessary, then it's necessary. And we keep moving forward. I started a Liquid Protein Train today, and have had over 100 grams of protein. I'm so thankful for Susan Maria Leach. She's my angel. Anyway, I'm feeling okay tonight, still some pain, but, like I said, we keep moving forward.

I haven't lost a pound since last February, I'm hoping this LPT will jumpstart it again and keep my hands away from the nasty carbs and sugar and focused protein, protein, protein! I've had to fight my head all night about the frozen Jack's pizzas my mom baked, but I have succeeded! I didn't even touch it! WOOO!!

It's getting better day by day. And I have a lot of support and friends in this journey. That I know. I'm looking to pay it forward a little bit, and use my knowledge to help more of the misguided bariatric patients out there who really want this to work!

School's going good. I'm a bit behind, I've been missing days because of my tummy pain, but it's okay. I know I'll make it through, and then it's onward to graduation and then -hopefully- to U of M!!! YAY! For a double major in Psychology with a focus on bariatric patients and Binge Eating Disorder and Nutrition with, again, a focus on bariatrics.

Life is looking good, my friends. Despite my obvious lack of a boyfriend, (and oh, have I been feeling it now that EVERYONE around me has someone else to turn to), I'm okay. I suppose the right guy will come in time.

Anyway... keep moving forward, everyone!

Ash

Yes, it has. It's been forever since the last time I've updated this thing. But with everything weighing so heavily right now, I need to get a lot of things off of my chest.

It's been a rough road since surgery. It's taken me forever to figure out that life will never be the way it was pre-op, and that I am in control of my own destiny. I know it's been particularly frustrating for my family. They only want to see me succeed and yet, I often doom myself for failure before something even begins. It has taken over two months for a gradual process to begin within me. That is the process of realizing that I am seventeen years old. My parents are no longer responsible for me, I am in charge of my health and my life.

Needless to say I've sat around for the past month pitying myself and the fact that I can't eat like a "normal person" anymore. It's been pathetic, really, and I can see how people could get so frustrated and angry with me. On top of it all, I've been having horrendous mood swings and I get irritated so easily that it seems that my family would much rather just steer clear of me then encounter a situation they'd rather not.

I take responsibility for my own actions, though... or lack thereof. I've just resumed drinking protein again. For two weeks after my one month checkup, I refused to drink the cheap chocolate flavored beverage my dad had bought for me in Wal-Mart. I just wouldn't do it, because everytime I tried to choke one down, I would gag. Finally, I ordered some Matrix Cookies 'N' Cream and Nectar Caribbean Cooler protein powders from a place called bariatriceating.com. The Matrix powder was lovely, I was so impressed. The Nectar, however... I don't know if it's just because I used water as opposed to mixing it with Crystal Lite. What I do know is that it tasted like the worst imitation of a Pina Colada I've ever had.

Still, as I said, I've been unmotivated and pitying myself for the pains that I've felt, the "friend" that I felt I had lost in food. What pish-posh. Tonight it was one big dawning moment and then "Eureka!" I decided I wanted to take care of myself. To throw my mind, body, soul, and spirit into getting healthy, taking it easy, and losing weight. I want to be healthy, I want to be free. And there is no way I'm going to get there by pity and blame and moping around the house.

Dr. Frantzides gave me the miracle of new life, restored and refreshed. I will not let him down. I refuse to take this opportunity for granted. I want to win at this, and there's only one way to do that: by devoting yourself to recovery.

In other news, I'll soon be finished with the 11th grade. Hopefully I pass all of my classes. My medical waiver I received from the school states that I need only pass any two of the following three: 1st Marking Period, 2nd Marking Period, Final Exam. Therefore, since I pretty much failed every class this marking period but Algebra (the teacher was nice enough to give me credit, despite my lack of, well... caring, I guess?), I have to pass all of my final exams. And with my Economics class I have to pass the current marking period and the final. It's complicated, but I may end up having to take some credit recovery courses over the summer in order to graduate on time with my class next year.

I'm getting a job this summer. Well... hopefully. I've applied at a bunch of places, most of which are fast food. Before surgery, working in a fast food restaurant would've been like putting an alcoholic behind a liquor counter. Now, though, it's changed drastically. Not only could my stomach physically not handle fast food, I'm starting to find it rather repulsive. Of course, there are always those old longings that pop up, "Oh what I wouldn't give for a slice of pepperoni pizza", but they don't tempt me for very long at all. The thought of the pain and sickness I would endure from consuming fast food items is enough to keep my hands in my pockets and my mouth shut. Either way, it's a steady cash flow in my bank account, much more steady than babysitting, and with all of the money borrowing that's been going on in my house lately, a nice flow of cash in my direction would be greatly appreciated.

Soon, it will be summer. This is exciting for me for a lot of reasons. Firstly, it takes much of the stress of balancing school and family and friends and hassles AND the first few months of post-op life off of my back. This will be great for a lot of the "stress pains" as I refer to them. Secondly, I'm making a trip to Ohio to see my Grandparents this summer with my best friend, Stephanie. It'll be great not only because Steph and I get to share the six-hour drive down there together, but also because my grandparents have a big house set back in the woods. A very secluded place with just this nice air of calming nature. It always relaxes me and empowers me when I get back to start living the best life I can live. My Grandma and Grandpa have never met Stephanie, but I'm certain they'll love her, most adults do.

To date, I have lost 62.2 pounds. It's not much considering it's only about twelve pounds in the last month or so. It frustrates me, and makes me worry as to what the doctor will say of my shortcomings and major stumbles. I've heard he's been known to yell at patients, and I don't think I could handle being anything less than superior in his eyes. I would hate to think I had failed so miserably when people had such high expectations of me. That's why over the next three weeks before my 3 month checkup, I'm hitting the protein like a fiend and going for short walks, to see if we can't blast off the whole weight loss thing again. 50 pounds in the first month was phenomenal. I just feel like people expected me to be around a 100 lb. loss at 3 months. It's not going to happen, I know that now, but maybe, just maybe I can make it to 75.

Meh. We shall see. I'm making a resolution to update this blog more often, as it is very therapeutic for me, even if no one ever reads it. So, until another time...

I have a HUGE update! As you will notice on the side of my profile, my status has gone from "Pre Op" to "Post Op". Entirely true. I am now about three weeks post op and feeling great! So here's the deal: It turns out we weren't able to fool the insurance company. I was being naive about that. They're smarter than a lot of people give them credit for, and besides, it's a felony I think. So anyway, Dr. Frantzides was going to give me a 50% reduction in the cost of the GB... but that was still about $8000, and my family still couldn't afford that. My dad had called one day to talk about payment arrangements but Jerrie said they didn't do that, they took a credit card or a Cashier's check. We were bummed. THAT'S why we were going to have to push back my surgery date. My parents were trying to keep all of this from me until about a month ago when my dad phoned the office to update and checkup and all that good stuff. Well Cynthia told my dad that the CBS Early Show was doing a piece on GB and my name popped up because I'm a teenager and they wanted to do a story on me. My dad said there was only one problem: we didn't know if I'd be able to have the surgery because my family couldn't afford it. Well, Cynthia transferred him to Jerrie, who told my dad that ever since my initial consultation everyone around the office had been chewing Dr. Frantzides' ear off about me. :) I told you I can charm. Anyway, Dr. Frantzides decided to perform the surgery Pro Bono. Which means free, for those of you who don't know Latin. At first, he was going to go out of his usual hospital, Evanston Northwestern, but then Jerrie said what was the point in making us pay thousands of dollars worth of hospital fees if we couldn't afford the GB? So Dr. F., bless him forever, went to the board at St. Francis Hospital in Skokie and asked them to accept my case, which they did. We left for Skokie on April 1st. April 2nd I had to do the bowel prep kit which was the most awful thing I have ever done in my entire life. I had my sister holding my nose and my best friend grasping my hand through the whole jug. The morning of surgery they took me right up to my Pre Op room, explained everything to me, CBS was there (they had been at my house the previous Friday interviewing me and my parents), the anesthesiologist, Dr. Theo came in and explained everything to me. I had to drink this horrid tasting antacid and then they started an IV on the back of my hand. Before I knew it, they were wheeling me back to surgery. Being that I'm only 17, saying goodbye to my mom and dad and sister was probably the hardest thing I've ever done, and I cried for a little bit. I wasn't really nervous until we got into the operating room. It took a little while for me to fall asleep, but I did. When I woke up, I don't remember being in pain at all but according to Lesley I was moaning and crying and stuff. Hahaha. Anyway, they wheeled me up to my room where my family was waiting and got me all comfy. I had an escort... I can't remember his name (anesthesia, people) it was either Brian or John... hm. Anyway, he was the biggest sweetheart. I had some great nurses: Tessa, Tita, especially Marie, my darling. She called me her daughter and called me beautiful. It was great. They make you get up and walk the night of surgery but for me it wasn't that bad just because the effects of the anesthesia hadn't completely gone away yet. So... yeah. I was there Wednesday and got discharged about 4:15 pm on Thursday. The 3 hour ride home to Michigan was horrendous and painful, but I made it. Now I'm 3 weeks out, about 40 pounds thinner, and starting to have a reason to smile! My one month checkup is May 3rd and I can't WAIT to get on that scale! This has been an awesome experience, a miracle from God, I know that. I owe my life to Dr. Frantzides and the people of St. Francis and I will never EVER be able to repay them for all they have given me. I'm just so happy now.

Update time! I have United Healthcare, an insurance company that normally is amazing about approving people for this surgery. However, my mom works at a hospital near where we live so we have a special branch of UHC called IBA Self-Funded. It's the people there that are making this so hard. They told my parents and Dr. Frantzides' office that they wouldn't approve me because I was seventeen. They wanted me to do this thing called the LEAF program at Bronson (my mom's hospital... where she works). LEAF Is a medical weight loss program, non-surgical. Then, if the LEAF program wasn't successful for me, they wanted me to wait until I was 20 or 21 to have surgery there at Bronson! Well, no. It's not gonna happen. Bronson JUST recently added their Bariatric program and personally, I don't feel comfortable being a Guinea Pig for a Bariatric program in its infantile stages. As I said before, I'm a very nervous person and knowing that I have professionals with the utmost experience and sensitivity is the most important to me. God bless Dr. Frantzides. My mom called to inform him of the problem and Jerrie just said, "Oh that's no problem. We'll have her get an Upper GI. Chances are she has a Hiatal Hernia, anyway from her weight. We'll just tell the company THAT'S what we're operating on." Ha!! So, we kept scheduling pre-op stuff and didn't get discouraged. My PCP within Bronson is willing to work with me apart from the insurance thing and said she'll send a letter of approval and recommendation to Dr. Frantzides. She also referred me to a Dietician who I buttered up, no problem, and who also said she'd adore working with me pre and post-op to achieve my goals. (I can lay on the charm when I need to). The day after my Dietician consult, I had the Upper GI appointment. The gas crystals hurt because they tell you not to burp but your body's saying "I HAVE TO!" but really it wasn't difficult or painful at all. It was over in a flash, they called back about five days later and said I really do have the hernia! Which is actually GOOD news now! Heehee. So now we go ahead with all the scheduling. However, we're going to have to push back my surgery date. It's really sad because I wanted to get it done as soon as possible. But with me being in school and all, it's hard to schedule appointments because I've already reached my limit for absences. The earliest the Cardiologist can see me is April 4th, and yeah... that would have been AFTER my surgery. So we're pushing it back to the second or so week in June, after I get out of school. It'll make it easier to recuperate and adjust to post-op life before I go back to school. Plus over the three month break I'll be considerably lighter than when I left! I'm okay with it, really I am. It means we can spread the pre-op testing out a little more and I don't have to have this whirlwind of pain and medicality. By the time graduation rolls around for me (which is next June.. of 2008) I should be down to about 185/190ish... estimating, of course... but hey! That's amazing! Senior year's gonna rock and college is gonna be even better! In short, Ashlee is a happy camper. :)

Wow! Dr. Frantzides is really REALLY detailed. We had to wait about an hour after our appointment time was actually scheduled for before anything happened and then about another half an hour after we got into the doctor's room before he came in. But my God, was it worth it. He explained everything from top to bottom, and I don't think he left ANYTHING out. I felt really at ease when he told me about his stapling technique that reduces dumping syndrome and the fact that I don't have to lose weight to actually get the surgery. In fact, Dr. F. and his... partner? I guess? Lesley were astounded that my dad, who also had the surgery about two years ago, had to lose about 50 pounds before the surgeon he went to would even think of operating. I feel very reassured with him that I'm working with the best, and that I have the best caring for me. It's good to know. I'm a little scared about some of the pre-op testing. (The blood gas, especially), but at this point more than nerves, I'm feeling a sense of "Let's just get this all over with and get to the surgery so I can get my life started!" I've been overweight all my life. And I feel like I finally have a chance at normalcy... maybe even snagging a boyfriend within the next two years. ;) 

Anyway, calling later today or Monday to schedule an appointment with my PCP so she can write up lab orders and get started on her letter to the insurance company and whatnot. I'll probably get the blood gas the next day or so... just to get it over with. I'm stupid, I know. :) I'm excited to get this journey started!!