happyteacher

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Well, it has been three years. I did manage to survive year two without regaining past my goal weight. But, even with that I am in need of working on my weight. I was down to 185 for a long time, and just plain old feel better at that weight. I started having weight issues after my double mastectomy this past April, and I am not even that clear on how my of my weight change is due to adding fat versus implants. Because of this, I am going strictly off of how I look. My clothes certianly still fit, but my Jcrew slacks no longer have any extra room in the waist. They are not overly snug, but any more of a gain and they will be. So, my goal is to take off the 10 pounds.

My eating has really deterioriated over the last several months. I am one to really eat bad choices at night, and when I exercise in the evening it really shields me from this. I have not been able to exercise since April. I am still too sore from my surgery a few weeks ago, but expect to be able to at least begin walking in about a month. I really want to be able to get back to using the elliptical. i can work on upper body issues closer to summer. 

Today I recieve my package with a month worth of meals. I found a Groupon from personaltrainerfood.com that sends through meals for the month for $200. The catch is that there is only one servng of protein, and all of the rest of the meals are veggies. Right now though, that actually sounds pretty darn good. I have been neglecting veggies for a while and have been craving them. Everything is frozen and individual servings so it couldn't be easier. I am going to do these meals along with 2 shakes (100 calorie version) a day to get my protein levels up. This program will go along way to stabalizing my blood sugar levels, which have really been off lately. I can feel the roller coaster that I am on and am so done with the incessant cravings I have been dealing with. 

Size wise I am a 14 tall upper body and a 12 tall in slacks (Jcrew sizing) or a large at Old Navy. Weight is at 194.7 this morning, with a bit of that being from swelling. Even with the extra pounds I still look and feel great, although very out of shape from the utter lack of exercise for the entire year of 2014. I realized today that for all of last year I was only cleared for exercise for a total of 6 weeks out of the entire year. I feel fortunate my weight isn't more out of whack than what it is!

So, new year- new goals. Off to a good start!

So if you are reading this please know that I use the blog to sometimes mark certain events so if I cannot remember further down the road when something happened, I can look it up here.  This is that type of post.

I noticed last week that my blood sugar levels seemed to be all over the place.  Previously I had issues with low blood sugar, but what I was noticing was glimmers of what I felt like prior to surgery... high blood sugar levels.  I never tested prior to surgery, but did have Ha1c at 6.4, glucose average at 134. Prior to surgery I would have experiences of being super light headed and knowing I needed to eat, and sure enough 15 mintues after eating I felt a ton better.  No lightheadedness or anything this time, but an awareness that I was feeling a little off. So I ordered a new glucose monitor and fresh supplies with the intent of tracking for a week to see if anything popped up.

Current weight is 190.  I have had a spike since the double mastectomy and have been working on it off and on over the last couple weeks.  My highest was 196 after a total carb binge weekend, and 6 pounds came off rapidly. Since that point I have a couple days of low cals and on plan eating, off set by a day or two of some sugar/carbs but calories not exceeding my normal threshold for maintaining. I find it odd that I have not lost a bit more doing this and am wondering if the high blood sugar levels are playing a part in it. I will be tracking that carefully as well. Just realized I should put another columon on my spreadsheet with weight. I wear a size 12 still. At 196 I could wear most of my 12's, but some were too tight. At 190 I can wear all of my 12's but still find them more snug than I like. I will definetly get my weight down to 185, and at the moment targeting 180. I loved before how the 12's fit great through the hips and thighs, and a little loose on the waist.  All of the pounds seem to be falling on my waist and hips at the moment. 

Damn. First check was yesterday and I was 191.  I checked it 3 times thinking maybe due to the new device I just mucked it up somehow.  Different fingers, and it went 189 up to 194.  Shit. So immediately decided to test many, many times a day and document exactly what I was eating, drinking, and exercise to look for patterns. Later that day by a few hours and after eating pulled pork with light bbq sauce I was at 116. Later that night after a bag of veggie straws, a cup of popcorn, and a ounce or so of chocolate spread out over a couple hours I was at 179. Sigh.  Next morning after 9.5 hours of fasting I was at 106. I took my vitamins and meds, had a couple cups of coffe with about 1 ounce cream, and an hour of exercise and I clocked in at 116. Wtf? Anyway, I am due for my physical.  I am going to log meticulously between now and then to chat with the doc about this. 

Double mastectomy wise... I hurt. My tissue expanders continue to be painful, but it is different than early out  My ports get sore from exercise or normal use of arms.  Occasionally the tissue expander still shifts over and smooshes a nerve or triggers muscle spasms.  Nothing terrible and very easy to deal with while on summer vacation. But I am worried about the soreness getting terrible again once I go back to work. I will have no choice but to use my arms in school and when I went back to work post op last Spring I was in a lot of pain all the time.  But I will worry about that later when it happens, if it happens. All I know right now is that my exchange is schedule for mid-December. That can't come soon enough. I should be eligible for the surgery earlier, but I want to miss the minimal amount of school as possible. If the pain is too much though, I will see if I can go in sooner rather than later. 

I have been so very happy not having to take medicines relating to the cancer.  No more anything! I cannot believe some days how much better I feel, especially compared to prior to the sleeve surgery. I think this is why I am so intent on getting a handle on the blood sugar issues. I have no desire to lose any shred of how good I have been feeling and going nearly medicine free. I still feel likje maintenance is going very well despite the recent trend up on weight.

Back to basics:

1. No drinking for at least 30 minutes after eating.

2. Go high protein.  For me this means 110 grams plus, but for smaller women it would be less. Lean protein too, or protein shakes. 

3. Green leafy veggies, and fruit that is low on the glycemic index.  Lots of veggies are Ok, fruit in moderation.

4. My best days are always the ones where I start with a protein shake.  My very very best days are when I have 2 shakes in a day.  Premier RTD for a meal replacement (30 grams protein) and EAS Lowcarb advantage for a snack (100 cals, 17g protein).

5.  You will have to decide if incorporating planned snacks will help or hinder.  I am hypoglycemic, so it is important.  Others do better just by eat 3 meals a day.

6. Have a list on the fridge of things you like to do instead of eat, then use that list.

7. Exercise. I would set a target of 30 minutes daily, but usually would end up doing an hour or more.  If I set my daily target at 60 minutes, on days I was tired I would not want to start because it sounded unattainable. When I did start though, I tended to do the hour.  So, set the goal at something you can live with and start, then exceed  as much as you can. 

8. Consider carbs.  Many do well at 40 grams a day, I do best cycling 30 grams at a meal and 15 at a snack.  Too much carb even with lower calories for the day will trigger a nasty insulin flood/cravings/hunger cycle that will increase your overall calories. Avoid that. 

9. Log and weigh everything.  Plan you meals and snacks.  Rid your house of all junk food.  Stay away from drive-throughs. Prepare your own meals. Shop only lean meats and produce, nothing processed.  Avoid white carbs (white flour, rice, sugar, etc.)

Heres' to clean eating!

Well, I finally did it.  I have known for a while that I would be getting a double mastectomy and it finally came about on April 15th.  I flunked an MRI so waitng until summer wasn't an option.  Missing that much school was seriously not cool, but it was unavoidable. This surgery was different too in that I ended up deciding to tell folks at work prior to the surgery what the surgery was.  I knew coming back it would be terribly obvious and I was hoping it would spare constant uncomfortable conversations.  I made the right choice, as it was much easier to talk with people openly about the process, the importance for women to be screen regularly, and benefits of the prophalactic procedure.  (With what they found most women would merely have had a lumpetomy- the BMX was due to family history and a crappy genetic profile.)

I am in the middle of the reconstruction process right now.  The tissue expanders were causing me a lot of pain for a while, as they were resting on a nerve.  Nerve pain just plain sucks.  Going back to work was very difficult, and in hind site I really should have taken another 2 weeks off.  The last drain didn't come out until just a few days before I went back, whereas most women have them out a week after surgery.  I just wans't healed enough.  But, I struggled through.  The kids were great and helpful, and it was good to be there to close out the year. 

It has taken its toll on the weight loss journey though.  I have not been able to do any regular exercie since mid December of last year (abdominoplasty). I have reached a point that if I am not moving around too much during the day, I can walk 3-4 miles in the evening with my husband, so on the right track at least.  The medical leave from April helped a ton with the abdominoplasty recovery... I lost a significant amount of the persistent swell and discomfort (particularly in the Mons area) during that time.  I am very bummed that backpacking is not an option right now... it is going to be a very cool summer here in Michigan and perfect for that.  My goal for now though is just to get moving again, and maybe in the Fall I can do a light trip here and there. 

My weight has been hovering from 186-190 during this recovery.  I need to take some of that back off.  I will be working on that over the summer.  

Clothes wise the abdominoplasty was wonderful.  I am still a size 12, but now the waist is comfortably loose, as compared to tight and uncomfortable with everywhere else fitting well. I love how I fill out slacks or a dress now and am very content with my size.  I am not sure if I will have to bump up a size in blouses after the reconstruction is done though- right now a large works well, but I don't have a lot of room in the chest area.  I am hopeful when I am done I can keep the size, as going up one makes everything loose in the shoulders and waist area.  

I am about 4 months out from the TT now, and doing great.  I still cannot believe how flat my stomach is, and I never thought even with the TT my results would be this good.  I am so glad I went through with it!  I am still not healed up all the way though.  In the last 3 weeks or so I can finally go on walks with my husband without it causing significant swelling so that has been wonderful.  Still not ready for the elliptical or lifting much of anything.  I have very mild soreness that comes and goes at the bottom of the rib cage and in the mons area.  I can't tell if the mons area is still swollen, or if this is just how it is.  My mons area does portrude a bit more than what I would like, but not enough to be self-conscious about it or anything.  I still have a lot of numbness, particularly in the same areas that I am still sore.  I am hopeful that I continue to regain sensation and lose the numbness. doc said it could easily take a year.  Some women never full lose the numbness.  Even if this is as good as it gets though, still totally worth it.  I lost 5 pounds of tissue and on the day of the TT weighed 179.  I never really saw a drop at all on the scale though.  Today I weigh 181, so at least despite not being able to exercise I am doing Ok with the weight management. 

I am going in 2 weeks from now for a double mastectomy.  I am experiencing a bit of surgery fatigue, but also can't wait to eliminate as much cancer risk as possible.  I feel like the disgifuring part will not bother me overall, espeically since of have the experience now of the TT under my belt.  I could be wrong though- I won't know for sure until I am post-op.  I have been through disfiguring surgeries before though (lost an eye as a kid) so I am completely confident that I will rebound just fine.  It I wasn't married, I wouldn't even bother with implants- but I think it will be super important for my husband and I am happy to do it for him.  Now in 10 years when it will be time for an upgrade, probably not.  But I will cross that bridge when it arrives. 

I am squarely focusing on the positves for the BMX.

 1.   Reducing risk by 90%-95%, priceless!  I have been going in circles for 3 years with skin cancer so this will be a serious load of my mind.

2.  Hopefully I don't have to wear a bra.  I am not sure about this, but I think once everything is said in done I will only need to wear a bra when I exercise.  This is a big deal for the 6'2'' chic, because straps on bras are NEVER long enough making them very uncomfortable.  Camis without bra straps showing- here I come!

3. The girls have taken a beating with the weight loss.  Major deflate, major shrinkles, and major droop.  This just won't be an issue when I am done. I am looking forward to eventually being perky and choosing to have a smaller size than what I currently heft around.  Having a C cup sounds wonderful!

What I know will happen, and dread just a little:

1.  Numbness.  It is going to happen and it will not go away.  I have experienced enough of this with the TT to know it will bother me.  People say though that with enough time passing, it becomes a new normal and not a big deal.  I hope so. 

2.  Implants that will double as ice packs.  I really dread this.  I freeze all winter.  I have to wear my winter coat in my classroom for the first hour I am there.  Many times when students arrive, I wear a hoodie over my sweater or something.  Implants get cold and feel like icepacks on the chest from what I am told.  I just don't have a good answer for this, and pray that eventually I adjust or figure out some strategies to help.

3.  Pain.  I am reading that up to 30% experience permanent nerve pain.  I has some cancer removed from my back and dealth with nerve pain- it was aweful.  From what I read the women who do have the pain say it is very manageable though, so that is reassuring.  The nerve pain from my TT has been no problem for me.  Hopefull that is how it will end up.  

4.  Risk of complications.  I know going into this that it could happen.  I am so blessed that during my last several surgeries over the last 3 years I just have not had any complications.  I pray this streak continues. 

The worst of the recovery appears to be over, not that any of it was that bad.  When I first got home I needed help getting in and out of a recliner, and could not sleep in bed for a few days.  Once i could go to bed, it was only with pillows stacked high enough to keep my in a reclined position.  I started with 4 drains that needed to be emptied and logged 3 times a day.  They did cause a little soreness, as the tubes were internal and sewn into place... but nothing intolerable.  I spent pretty much the first 2 weeks in the recliner and only moved around enough to ensure blood clots and such would not be an issue.  Got 2 drains out at the 10 day mark.  I was pretty darn nervous about that, but it ended up only stinging for about a minute.  I was sore though from it for a few days, but it healed quickly.  By weeks 3 and 4 I would go out for very short trips.  If we needed just a couple things from the grocery store I would go.  Saw a movie, but was pretty sore by the end.  I would just leave the house once a day to try to get a feel of how well I could move around to begin to determine if I could go back to work.  It was pretty apparent that the remaining drains would have to be removed in order for me to return.  I got them out 2 days before school resumed, and was far more sore with these two.  I was very blessed though, because a huge snowstorm with artic temperatures hit on Sunday night so I had 2 snowdays... just enough time for the soreness from the removal to heal enough to not bother me.  Yesterday I was able to walk 70 minutes on the treadmill and realized after that it was the first time I could walk that long without my back hurting- beautiful!!  Not sure if it was just a fluke, because I am wearing my medical grade spanx and everything is supported, or from losing the pannis... but I am praying it is the pannis.  I read from another poster that her back pain was relieved with this surgery- that would be incredible!  I still cannot get over how flat my stomach is- so glad that I went through with this and worth the extra 2 grand for the vertical cut and muscle tightening.  I am still swollen so do not have a true sense of the final results, but even if this was it... so so much better!  The scarring is pretty frankensteined out... around both hips and vetical cut up until just where the breasts meet.  That will fade though and I have so many friggin' scars from cancer excisions that it doesn't phase me.  I was never one to want to wear a bikini or show of the middrift anyway, and my husband could care less.  All in all.... it went great!  I am curious though what my final size will be... for sure can't get ride of the size 12's at the moment and the swelling is making the size 14's feel a bit more comfortable on the waist.  May be going into work looking a little sloppy for now, but oh well. 

Well, I am four days shy of my 2 year surgiversary.  Things have worked out so much better than I ever thought at the beginning of this process and I couldn't be happier.  My weight has been holding at 178-182 up until PS.  I had had an tummy tuck this past Monday, and they removed about 5 pounds of tissue.  Frankly, I was surprised it was only 5 pounds because it sure seemed like more than that!  The recovery from the PS is definitely more difficult that the vsg recovery, but still very tolerable.  It has been 6 days since surgery and I still struggle a bit getting out of a chair or going to bed- I just have to take it slow.  Dealing with the drains turned out to be easier than I thought, although they prevent me from getting dressed in any real clothes- not that I feel like going out anyway.  The scar lines are crazy- I knew what to expect, but it is something different when you see it on yourself.  I can already tell I am a whole lot flatter already, and that is even with the significant swelling everywhere.  The binder has not been bad at all, and I prefer wearing it to not wearing it.  I am very grateful that somebody I know warned me to take of a month though, and not just two weeks.  I am feeling better each day, but dang- going back in a week would have been terribly difficult.  I am appreciating the time off more than any other time since I have been teaching.  

Going in to PS I was wearing a size 12 quite comfortably.  I have read that at first I may not even be able to fit in those due to swelling when I return to work, and in other places I read that dropping a size or two is not uncommon.  I have no idea where i am going to end up.  I was content in my 12's, other than the muffin top from the extra skin and terrible drooping in the abdomen.  But a 12 with everything tightened up is just fine with me.  I can't imagine buying a size 8 to be honest.  My daughter is exactly my height (6'2'') and wears a size 2- and looks great.  So it isn't that i think I would look emaciated or anything, just hard to wrap my head around.  

So, at six days out from surgery here is a summary of the experience.  I don't remember waking up this time, which is weird because I always do.  It was much better this time though- normally I remember waking up vomiting.  This time, the nausea was extremely well-managed.  This is the first time I asked them not to give me morphine, and for sure that was the best choice.  In the hospital I was not terribly uncomfortable and found it to be actually easy enough to rest.  It was very quiet there and I had my own room.  The nurses were in periodically- enough to feel like if I needed anything it would be taken care of, but not so much that I couldn't rest.  The adjustable bed was very helpful.  I was bummed when they took out the foley because I was worried about getting up to move around, but it was not an issue.  Walking at first was hard and I couldn't do much, but that got better pretty quickly.  Joe went home that night and came back at 11 the next morning.  I was realy to leave by then, but they couldn't track Dr. DiNick down to get released.  Not a big deal, but was discharged around 7 that night.  For the first time, it was easier being in the hospital than at home but I was concerned I would be billed for part of the stay since insurance was only covering part of the procedure.  

At home, I didn't even try to sleep in bed the first few nights, but instead the recliner.  I was very sick of always having to be on my back even in the hospital, but it has been Ok.  Had my first shower on Thursday, and ended up having my oldest daughter help me.  She was perfect at it, and it was a relief to get the first one done and everything cared for.  She has been invaluable, since the hubby pretty much melted down on me when we got back home and hasn't been able to help much at all.  First day home he was in a terrible mood and diggin in on the kids, leaving for long periods, and eventually just broke down at night.  He was angry and felt like nobody respected him or cared about him.  I really felt like as he was going through this that he wasn't able to really admit what was bothering him.  He had started dieting almost obsessively a little before surgery, and the intensity and follow-through is unlike him.  It was even more so when we returned.  He also had been saying for a few weeks prior how I was going to divorce him after surgery- completely irrational, but real for him.  He finally felt comfortable enough admitting that the problem was with him, but wouldn't define it further.  I think he is going to need a lot of time for his brain to catch up with the changes in my body and to realize that I am every bit just as married to him as before and that I love him exactly the way he is.  It will take him some time to feel that though.  I was completely unprepared for this and in hindsight should have spent more energy helping him to transition through this.  Once I am healed enough to give him more attention it will help.  Pain wise, I have been taking 2-3 pain meds per day so far.  The script reads to take 1-2 every 4 hours as needed, but 1 every 6 hours or so has been enough.  I will be very glad to get to a point that I don't need them though.  Ugh. No regrets about the surgery though, and I expect by the time I need to return to school most of the current issues will be resolved.  

All in all, a great two years!

Things have been humming along beautifully.  Decided to take a few more pounds off and was frankly shocked at how easy it was.  Approved for plastic surgery and have a date, but likely will reschedule due to the conflict with school.  Not sure yet because I am in the process of pursuing a double mastectomy and I think I can have both procedures done at the second phase of the mastectomy process.  Waiting on the docs to coordinate and get back to me on the insurance status.  Maintenance has been wonderfully easy.  I never feel deprived and have an easy time with it so far.  I still exercise 3-4 times a week, mostly long walks.  This is for sure becoming my new normal :) 

Just to document some numbers- 

Weighed in at 180 this morning, 110% EWL, size 12 skirt, size 14 top.  Shoe size seems to have leveled off at 10.5 (not that I can find that size anywhere!). 

It is June 30th today, 2013.  My weight is sitting at 185, but will drop a few pounds over the next few days as I shed the monthly bloat.  Maintaining my weight has been no problem, although I have had a few times I hit my designated weight that triggers going back into weight loss mode for a few days.  The great thing is that when that happens it comes off pretty fast.

I hit goal 10 months ago, and have since lost another 10 and kept it off.  I dropped my designated trigger weight down by another 5 and I am contemplating dropping it down another five.  We'll see.

About 2 weeks ago I had my first plastic consult.  Found out that I do not have enough fat left to use in an upcoming (yet to be scheduled) double mastectomy.  I was surprised by that, and a little disappointed that this is not an option.  Oh well.  My biggest hurdle is going to be scheduling this around the school year, as my insurance is changing in January, which may force me to go during the Fall.  I so hope that doesn't happen :(

Tried on some dresses today just for fun and was shocked that I could pull off a medium on my lanky frame.  Aside from desperately needing spanx to go with it, they looked great!  Wish there was a store around that carried talls for this!

All in all things have gone splendidly!

Just checking in for the surgiversary.  My weight did my  normal fluctuation with water weight, but weighed in at 190- right on target on the 19th.  Today at my physical I was 188 fully dressed and was pretty surprised.  My sister who is trying to lose weight without surgery has hit her first plateau and struggling a bit.  Hopefully she pushes through and keeps making progress.  My youngest wanted to start juicing after seeing a documentary, and it is good to be doing this again.  I always like doing it, but I am super lazy about it so hopefully she keeps me going.  For the first time, the hubby is drinking it so for sure long term habits is now more likely.  

At the physical today the doctor put my on A.D.D meds.  First time in my life I am going to try to treat it this way and I am a little nervous.  I think I will wait until Saturday to try the first dose, but have not decided yet.  I sure hope it improves my driving!

Overall I feel great and maintenance is going very well.  I am experimenting with not tracking this month, but still weighing in once or twice a week.  Just curious to see how it goes, and if I start to slip I will go right back to tracking.  

Peace.