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I'm converting my profile over to the new format and figured I ought to post an update while I'm at it!

I reached my goal weight (134 lbs / BMI of 23 / 202 lbs lost) in early June, at almost 18 months post-op. 

Since then, I've been following my dietician's instructions to NOT track every bite I eat ("that's not normal!") but, rather, to eat like a "normal person" - which evidently means to "eat when you're hungry, stop when you're full, try to make healthy choices most of the time."

(Hmm. Who knew?!)

It seems to be working, because I'm eating pretty much whatever I want (but trying - usually - to make healthy choices) only in tiny amounts, of course, and I've maintained my weight in the 130s for nearly 6 months. 

(Literally - the lowest I've seen is 130, and the highest since reaching goal was 139. I'm usually between 133 - 136, though.)

It's a little wierd getting my brain wrapped around the fact that I only have to be accountable to my body. On the one hand, even if it's not written down, it still counts, because my body will know I ate it. On the other hand, I find myself feeling guilty and like I'm "getting away with something" if I make less healthy choices, even though my weight is staying the same. 

It's hard to convince myself that if I'm not getting sick (never do) and I'm not gaining (so far, so good) I must be doing something right!

You can check back to previous posts to see all the details of where I started, but now I am wearing size 4 pants (and have even tried on a few pairs that are too big!) and small shirts. Pretty unbelievable. 

I would really like to have some reconstructive surgery at some point, but as long as I have my clothes on, I'm pretty darn happy with how I look. More importantly, I FEEL great. 

This surgery has absolutely changed my life and it's one of the best decisions I've ever made. 

In other family news, my brother (now 2.5+ years post-op) is still doing well, and my sister, Shar Pei Kay, is now 6 months post-op and doing GREAT!

Well, it seems I've been rather lax about updating things here, but here's a summary of where I stand now, one year out.

Since my first nutritional counseling appointment, I've gone from 341 lbs to 177 lb, which is a total loss (so far) of 164 lbs (about 5 of which was pre-op).

My BMI has gone from 58.5 ("Super Morbidly Obese") to 30.3 ("Obese" - but just barely. Those are based on my "clothed weight." If I use my "naked weight" (5 lbs lower) my BMI is now 29.5 which is only "Overweight."

I've gone from very tight size 26 womens Venezia jeans (had to lie down to zip them the morning of surgery!) to just-right (and one pair of too-loose) size 14 relaxed fit Levis.

Actually, I can zip up and walk around in the 12 relaxed fits, but they're still a bit tight to wear (but looser than the ones I was wearing preop!) and if I REALLY work at it, I can zip the 10s - as long as I don't want to breathe!

In shirts, I've gone from men's XXL & XXXL to men's Mediums, and some women's mediums. (I have both the men's and women's M's that range from quite loose to too tight to wear.) I think may even have one men's small!

I keep expecting my weight loss to slow down soon, but I've been losing about 10 lbs / month for probably the last 8 months or so.

As far as what I'm eating now - here's what my nutritionist recommended a couple of weeks ago, based on exercising regularly:

Calories: 1000 - 1200
Protein: 65 - 75 g
Total Fat: 35 - 40 g
Total Carbs: 100 - 120 g
Calcium: 1500 - 1800 mg

However, I'm really not doing much exercising (I know I should be!) and am generally getting more like 800 - 1000 cals, so here are the goals that I've set for myself, adjusted for that (plus some other research that I've done):

Calories: 800 - 1000
Protein: 60 - 75 g
Total Fat: 30 - 35 g
Saturated Fat: 10 - 12 g
Cholesterol: 100 - 150 mg
Total Carbs: 80 - 100 g
Calcium: 1500 - 1800 mg

And - if you're not bored yet - here's my average intake (per FitDay.com) over the past couple of weeks, which have been pretty typical

Calories: 858.23
Protein: 58.88 g
Total Fat: 31.09 g
Saturated Fat: 12.37 g
Cholesterol: 84.79 mg
Total Carbs: 76.64 g
Calcium: 1496.4 mg

So, I need to try to get a little more protein and Calcium and a little less fat, but other than that, I'm doing ok.

I saw my surgeon on Friday, and he says everything is great - labs, weight loss, what I'm eating, etc.

I have been very lucky throughout this whole process. Once I got past that whole "I've been cut open and it hurts like hell!" thing (which took 3 - 4 weeks) and finally found a protein drink that I could stand (EAS Precision Protein Grape from GNC - don't drink those anymore, though) it's been smooth sailing.

I've had no food intolerances, no complications, no problems at all.

I feel great physically, and I feel great about myself. I cannot believe the difference this surgery has made in my life in just one year.

I hope that everyone's experience has been, and will continue to be, as positive as mine has!

Happy New Year! I think I'm looking forward to this next year more than I have any year in a long, long time.

I'm recovering nicely from my surgery. I'm still sore when I move the wrong way, or try to do to much, but I just keep reminding myself how much better I feel than a couple of weeks ago, and how far I've come.

Christmas went well. I took some soup (cream of chicken, plus dried milk) and SF/FF pudding when we went to Christmas Dinner with Kris' family (at 11 days post-op). It was kind of hard, not being able to eat any of the "real" food, but not too terrible. By the time we'd finished opening presents, I was worn out and ready to go home, though. We drove around and looked at lights on the way home (which has become something of a tradition for us). I was hurting like hell, especially if we hit a bump in the road, but I'm glad we did it.

I started walking on Christmas Day. I went for 10 minutes the first few days, and now I'm doing 15 minutes at a time. I'm mostly walking in the house, but have joined Kris and Chessi (the dog) for the first leg of their walk a couple of times. I'm planning to join the YMCA soon, and am thinking of taking their water aerobics class a couple of times a week, in addition to the walking.

I had my follow-up visit with Dr. Ku yesterday. He says I'm doing great and released me to go back to work on Monday, with no restrictions. Of course, I kind of have mixed feelings about that :-) I told my boss that I want to keep my options open to work shorted hours the first week or so. I'll try for full days, but will leave early if I need to.

He also released me to do any exercise that I want, the only limitation being "pain and discomfort," meaning that if it hurts too bad, quit. I don't think I'll have any trouble following that rule! I do need to wait another week or so before I start with the swimming (or tub bathing) to let my incisions heal a bit more.

The nurse and PA (Hileen) both fussed at me for not getting enough protein. Of course, they didn't really tell me anything I didn't know; and of course they were right. Hileen did recommend that I try the Isopure powders and juice-type drinks from GNC, and we picked some up today. I'll probably have a juice in a little while.

My biggest problem, I think, with the protein is just remembering to eat, and making myself eat when I don't feel hungry. Kris went back to work last weekend, and since then, I've probably been getting in about 1/2 - 2/3 the amount of protein that I was before, because she's not home to bug me about it. She's threatened to call me every hour from work and tell me to eat.

Oh - and the most important part: As of my appointment yesterday, I weigh 312.7 lbs. The frustrating things is that I don't know exactly what I weighed when I had the surgery! Here's a breakdown on my various weights, and the amount I've lost since then:

9/10 First dietician appointment: 341 / 28.3
11/5 Last dietician appointment: 331 / 18.3
12/15 Post-op (full of IV fluids) 345.5 / 32.8
12/13 Surgery Date - Estimated weight?? 336 / 23.3

I think I'll go with the 336 as my starting point, since I'm sure I'd gained in the last 6 weeks before surgery. Of course, in a few months, it won't be too far off to just use my very beginning weight, but right now, it seems like I'm claiming more than I deserve. I know, I know, NO one really cares about that but me.

I had my Lap RNY with Dr. Ku at Hershey on Monday 12/13 and came home Thursday.

I will go back later and fill in the blanks about the surgery and hospital stay itself when I'm up to it, but for now, here's where we are today:

I guess I'm doing pretty well, things are getting easier every day, but I'm REALLY ready to stop hurting.

I'm doing my best to walk a bit (around the house) each time I get up to the bathroom, but there are a couple of incisions that still hurt with each step, and I wear out pretty quickly.

I'm supposed to be drinking 4 Carnation Instant Breakfasts (w/8 oz milk and 1/3 c powdered milk) or the equivalaent daily, and haven't even come close. I guess I've managed 3 the last couple of days.

Had some LF chicken broth yesterday. Kris got 3 scoops promod into 1 cup broth (for 18 g protein) w/o being lumpy or too thick. I had 2 of those and 1 CIB. After all that "cold and sweet" it sure was nice to have some "warm and savory."

Haven't finished my first CIB today, though. It doesn't taste bad, it's just that I don't care and I'm sick of it already. I think Kris is going to the store later and will get some beef broth, as well as some extracts to mix with the vanilla CIB, for some more variety.

I'm sipping SF lemonade between, but as long as it takes to finish one, there's not much "in between" time. I bought some jello and popcicles pre-op, but hate to waste time/tummy room on anything non-protein at this point.

On the bodily function front (ew), things are finally "moving." Wasn't too bad for me, but bless Kris's little heart for her help. (I"m not where near being able to bend enough to deal with those issues myself yet.)

Speaking of Kris helping me, I can't say enough how well she's be taking care of me, and how much I appreciate it. From *that* to making and bringing me food, helping me get up and around, and just encouraging me and listening when I whine and cry, she's been a real trooper and I'm going to owe her BIG when this is all over.

I talked to Dawn at Hershey today, and she said that they've recieved the approval letter from Capitol Blue Cross. My pre-op appointment with anesthesiology, etc is this Friday and my surgery is 2 weeks from today. I'm totally into "last meal" mode that this point. I refuse to eat anything healthy for the next 2 weeks! I'm starting to get excited about the surgery, but also starting to get nervous. I alternate between just wanting it to be over with, and thinking that it's all happening too fast!

Backing up a bit - First, Kris' boss told her that she didn't qualify for FML to take care of me after surgery, and that she'd have to work around everyone else's vacation schedule, etc, but when she talked to him in person, he was very helpful and checked the schedule and gave her a range of about a month during which she could take off.

10/15-18/04 - After doing so great with the diet last month, it just went all to hell this month. First was the camping trip, then I went to Texas the next weekend, and did a couple of "last meals" down there.  While I was in Texas, I saw my brother, who at that point was almost 6 months post op and down almost 150 lbs. He looks great! The whole family went to dinner, and he and I sat together and talked about the surgery the whole time. He showed me everything he was eating, how much, etc. I really can't get over how great he looks.

The morning that I left for Texas, my CPAP machine arrived. I started using it after I got home. I guess I've gotten used to it, but I seem to be taking the mask off in my sleep. The good news is that Kris says that I don't snore at all when I have it on.

11/2/04 - I'm Director of Volunteers of my county Democratic Committee, so about the time I got back from Texas, things really got busy around here. The last week or so before the election, I was at the party headquarters almost every night, and was there basically all day for the last four days or so. At that point, we were eating whatever someone ran down the street to pick up, so forget about any kind of dieting!

11/5/04 - My third appointment with Margarita and my consult with Dr. Ku was the Friday after the election. When we arrived at their office, we found that the electricity was out; evidently this happens alot when there's a lot of wind. I thought I'd lucked out and gotten away without weighing, but it came back on later.

I 'fessed up to Margarita about being basically out of control, food-wise, but ackowledged that next time, I know that I will just have to deal with the situation and do what I've got to do to eat the way I have to, post-op. That seemed to get me out of trouble :-)

We went back to the waiting room for a while, then we were called back in. Now the power was on, so I did have to weigh. I was up about 3.5 lbs, but still down 10 lb from my first appointment. That's much better than I'd feared!

I met Hileen for the first time, and I really like her. We went over the consent forms, etc. and then just as Dr. Ku was coming in, the lights went out again. We moved to a room with a window and finally had our consult.

I don't remember much of the specifics, but when it came time to schedule the surgery, I told him that Kris' boss has told her that December 13 would his choice, if she's going to be taking off two weeks, "but I'm sure you won't have that date available." Well, sure enough, he did, so there we are!

Now, I just have to wait to hear back from the insurance company (although I've been told that should be no problem with the policy that I have) and for someone to call to schedule my pre-op anesthesiology stuff.

After we finished up there, we got some lunch and we to visit our attorney friend to discuss wills, powers of attorney and living will. On the one hand, I figure if all that's in place, we won't need any of it. On the other hand, at the very least, we need to have the legal paperwork set up for Kris to have my power of attorney so that can authorize anything that's necessary and so that it's clear that she's my next of kin, so that they give her information and let her be with me the whole time.

11/8/04 - I saw my nephrologist today, for a long-resolved, non-weight-related kidney issue that I get checked on annually. He says everything looks great, kidney-wise, and that he sees no problems on that end for the surgery. Yea!

I talked to the benefits person at work again, and she told me that they're definitely keeping Blue Cross (whew!) but won't know til probably the end of next week what the coverage will be. It could be what we have now - $250 deductible, plus 20% up to an out-of-pocket maximum of $1000, or it could be $500/$3000 or even as high as $1000/$5000. Whoa.

As I said before, the new policy kicks in December 1, and that's when the deductible and out-of-pocket start over. I've (not surprisingly) met my deductible for this year, and am about $250 away from the $1000 limit. So, if I were to be able to get the surgery before December 1, it would ALL be covered. If it's after Dec 1, I'll have to pay the deductible and up to the o-o-p limit - somewhere between $1250 and $6000. She was quite sympathetic to my situation, so maybe they'll keep me in mind when deciding which coverage to go with.

I also talked to my boss and told him about the surgery. I explained all the insurance stuff, and that I have 13 sick days for this year. Combined with a personal day and holidays, that should get me essentially 3 weeks off, which will hopefully be enough, but I can't be sure. I also pointed out that what I do slows down in late November and December, but gets busy again in January, so it would be much more convenient for everyone if did it before the end of the year. He agreed to let me borrow against my 2005 sick days if necessary.

Kris has emailed her boss to ask about when she can take off work to take care of me. He's forwarded it to their HR person to find out if they will give her FML for me, since I'm not *legally* related. I'm sure that, whatever their official policy states, they have the descration to grant the leave as they see fit, so I think it should be ok.

I doubt there would be anyway to get it done in November, but I'm certainly going to tell Dr. Ku all my insurance woes and see if it's possible. I'm not getting my hopes up for that though, I'm just keeping my fingers crossed for December.

My second appointment with Margarita was at 2:30 pm, but of course it wasn't that simple. For one thing, we were going camping for the weekend with some friends at a cabin in Pine Grove Furnace State Park, which is pretty much right between home and Margarita's office. No problem, right? Well, it was no problem until Thursday, when we decided that we'd all take our dogs with us on the camping trip (5 lesbians and 5 dogs all in a little cabin in the woods!). The weather's been cool lately, so we figured that we would just have to leave Chessi (our 1 year old dog) in the car (for the first time!) during the appointment.

We got up in plenty of time, got all packed and were actually ready and waiting around til time to leave. I realized that was silly, so I ran over to the hospital and got my lab results, and got back home with still time to spare. Finally, we finished loading up the car, and got Chessi and ourselves all loaded up. By that time, we'd realized that it was nice and cool outside, but rather warm in the car. Rather too warm for our black, fluffy baby. What to do?!?

When we got to Margarita's office, Kris took Chessi for a little walk around the parking lot, while I went in and tried to talk the front desk folks into letting us bring her in. No dice, but no surprise. So, I went to Plan B....

When Margarita came out to get me, I said "I have a wierd request..." and explained that I really wanted Kris to be in on the appointment, but that it was too hot in the car to leave Chessi. Before I even had to ask, she said "So, do you just want to go outside?" Yep, that's what I was getting it.

First, we stopped at the scale, where I found out that I'd lost 13.5 pounds in the four weeks since my first visit. Wow!

I turned in all my paperwork and she seemed rather surprised that I had it all. She gave me an assigment, I did it. What's surprising about that?

She looked over my papers and called Dr. Ku's office to set up my first consult with him. I suggested Friday November 5, and they offered me a choice of 9 am or 1:40 pm. Since I have a 2:30 pm appointment with Dr. Kurshid on that day, I opted for the 9 am. Then I found out that to see Dr. Ku at 9, I have to see Margarita at 8 am. Ruh roh...

We went outside, found Kris and Chessi and had our appointment sitting at a picnic table behind the office. It was a beautiful day, and I'd like to think that Margarita appreciated the opportunity to get outside, rather than just thinking that we were wierdos for bringing our dog along.

She looked over my food journal and basically her only criticism is that I'm waiting too long between meals. I guess that's a relatively painless thing to correct. Then we went over all the bad stuff that will happen if I eat the wrong things after surgery, and she gave me a packet of information to read for homework before my next visit. It's all about what I can eat when.

Then we headed to the cabin, where we had a great weekend. I "came out" to our friends about the surgery and they were very supportive. As it turns out, another woman in our group, whom I met on the previous camping trip, is having the surgery in Harrisburg on October 21 (she was going to go on this trip, but it's too close to her surgery date). The first one that I told said "Good for you!" which was great to hear. One of other the women on this trip is a good friend of hers, so is already involved in the process with her. She actually brought it up and asked "So, I hear you're having the surgery, too?" The fifth person was new, she mostly just listened. They were all very supportive and at least pretended to be interested in hearing all about it. And they were all appropriately impressed when I told them I'd lost 13.5 pounds in the last month :-)

Kris and I went back to see Dr. Kurshid, the pulmonary specialist, to discuss my sleep study. When I weighed in, I had lost about 6 pounds, compared to what his scale said at my first visit, 7 weeks earlier. I'm anxious to see what Margarita's scale says on Friday. Dr. Kurshid told me that I have moderate sleep apnea (which I already knew) and said he'll send a prescription for a CPAP machine to an area home health company, and then he wants to see me back in a month. I got a copy of the reports from my sleep study and CPAP titration and then headed across the street to my PCP's office to pick up my other paperwork.

The receptionist there was less than helpful. I told her that I needed to pick up a letter from my PCP, a letter from the psychiatrist, and copies of all my lab work from September 13. She walked to a counter in the back and pulled my chart, which was waiting there for me to pick these up. I could see her shuffling papers and saw her pick up and move two envelopes and a bunch of other stuff. She came back to the front counter and handed me one envelope, which contained the letter from my PCP. I told her that there was also another letter, plus lab results. Back to the chart, shuffle, shuffle, shuffle, and she returns with a second envelope, containing the psych eval letter. I told her that I also need a copy of my lab results. Back to the chart again, more shuffling and back she comes with two pages of lab results. I looked over the lab report. The first page says "Page 1 of 2" and has results from the chem panel and fasting lipids and says it should also have the thyroid results, but they aren't there. (Later I realized that there should also be CBC results somewhere.) The second page says "Page 1 of 1" and has all the urine results (that stuff was for my nephrologist). Again, I send her back to the chart, more shuffling, and ... nothing. That's all that's there, and I'll just have to call the hospital for the rest.

When I got home, I called the hospital and they told me that I can just pop in, sign a release and get what I need in a matter of few minutes, so I guess I'll do that on my way to see Margarita on Friday.

Kris and I attended the WLS Support Group at Chambersburg Hospital. As luck would have it, Dr. Ku (my surgeon) was speaking, giving an overview of the surgery. I'd already heard most of it, but I was glad Kris got to hear it, since she wasn't able to attend the original group information session with me. I was surprised how many people were there! The next meeting will be on election night, so I'll be busy then, but I plan to go back after that.

To back-track a bit, today at work, the benefits woman came to talk to me about insurance. I had told her about the surgery some time last week and asked if there were going to be any coverage changes when our policy renews on December 1. As it turns out, the insurance that I have (Capital Blue Cross) is raising their rates something like 46% (!) so they're polling everyone who has that policy to see what they want to do. I explained that the other option (Keystone) doesn't cover the surgery, so I don't have a choice. They will probably keep Blue Cross, but might be increasing the copay or out of pocket maximum. Ugh.