quick update.

my surgiversary was august 5. 

i have lost 126 pounds.  i just did the cottage cheese test; my stomach holds 5 oz.  :P

I did the cottage cheese test this morning.  I know it's not the most accurate scientific test in the world, but I've been slacking a bit and was simply CONVINCED that I had stretched my pouch out beyond belief.  My pouch is between 4-5 ounces, which seems to be the average that I've seen people reporting online.  I felt "full" around four but um, stupid me didn't read the directions and ate until I was a little bit uncomfortably full- that was nearly 5 ounces. 

My weight loss is slowing down quite a bit.  I've had to cut out my personal trainer due to some issues with severe back pain.  I'm working to get back on track with that- I seem to spend most of my free time at doctor appointments, the chiropractor and physical therapy!  I can't wait to get back to feeling normal again.

Also, I think I've become a bit too carb-dependent.  No, I don't down ginormous portions of bread or pasta but I've been too permissive about having "just a tiny bite" of the things my friends are eating.  I plan to do the pouch test this weekend  and get back on track.  :)

I also have an appointment with an endocrinologist next week to see if my hypothyroidism and PCOS hormonal abnormalities might be screwing me up.

Here is a link to the basic test information:  http://www.sabariatric.com/life_and_success/cottage_cheese_test

"Cottage Cheese Test

How big is my stomach pouch?

Just about every patient asks this question. It is expected and appropriate that the stomach pouch will enlarge somewhat as the months pass after gastric bypass. Some of this enlargement is an actual increase in size, and some represents a softening or regaining of elasticity of the pouch and its outlet.

The real answer is that the functional size varies with many factors such as time of day, the amount of time taken to eat, mood of the patient, other medical issues, and most importantly, the type of food eaten. It is expected and appropriate that the pouch will handle a much smaller amount of solid food like chicken than softer foods like mashed potatoes or soup.

The cottage cheese test is a technique that was presented at the June 2000 meeting of the ASBS (and many times before that) by Latham Flanagan, MD. Dr. Flanagan is one of the founding pillars of bariatric surgery. He practiced in Oregon, and retired in early 2005. Dr. Flanagan designed this test as a standardized, reproducible measurement of the physical size of the stomach pouch in a person who has undergone a gastric bypass procedure. This test works less well for Adjustable Gastric Band patients, because the tested size of the pouch depends on how tight the Band is.

The Test

• Utilize a container of small curd low-fat cottage cheese. Begin the test with a full container, and perform the test in the morning before eating anything else (this will be your breakfast on that day). Eat fairly quickly until you feel full, ideally in less than five minutes. Note that the small soft curds do not require much chewing. The idea with the rapid eating is to fill the pouch before there is much time for food to flow out of it.
• After eating your fill of cottage cheese, you will be left with a partially eaten container that has empty space where cottage cheese used to be.
• Start with a measured amount of water (16 ounces, for example), and pour water into the container of cottage cheese until the water is level with the original top level of the cottage cheese.
• The amount of water poured into the container is the functional size of the pouch.
• If this is your first time doing the test – don’t panic. You are likely to find that the "cottage cheese" size of your pouch is much bigger than your surgeon told you he or she made it at the time of surgery. What is going on is that even if you eat quickly, some of the cottage cheese is flowing out of your pouch at the same time you are eating. Dr. Flanagan’s data indicates that the average size of the mature pouch by cottage cheese test is 5.5 ounces, as measured by this test. He has also found that sizes ranging from three to nine ounces have no impact on the person’s success in weight loss."

ok, i know... wls messes with your hormones.  estrogen is stored in the fat cells and when fat burns, all that estrogen is sent surging through your system.   yay.  the good news is that te weight finally seems to be coming off again.  i'm quite happy to see the scale moving down, finally.  i'm only thirty pounds away from my goal!  :)

on the down side, i think the combination of pcos + hormonal shift + pmdd= no fun at all.  af showed up 2 whole week early!  i was going through some bizarre emotions last week.  i was crying for no reason- for hours at a time and getting extremely snippish over nothing. i felt like i was going crazy... for real.  as in it's time to call my shrink and ask if i need to be comitted crazy.  then af showed up saturday night, which explained a whole heck of a lot!  but i am left wondering... i am ten months out.  is it normal to still be having such dramatic shifts?

Ugh... i feel like such a Moody Myrtle these days!  I've been crying for no reason and feel generally de-motivated.  Well, actually my mood is wavering a bit.  I want to "get going" and get things done but hours later, I tend to crash both mood and energy-wise.  I don't know if it's hormones- I'm ovulating and my PCOS seems to need tending to.  :/  Or stress... I've got plenty of that on my plate.  Or the meds I've been on for back pain.  :/  Also, the scale seems to finally be moving down but that means all that estrogen is now running through my bloodstream!  Ugh!  Can I scream now?

Seriously, I need to make some appointments for follow-up.  I need to see an endocrinologist to get my hormone levels checked; I haven't done that since before my surgery.  I need to start physical therapy for my back.  I need to begin the process of meeting with plastic surgeons and seeing what my insurance will cover.  I'm also in therapy for my mood issues and body image issues.  This surgery is a lot harder than I ever thought it would be, both mentally and physically! 

On the mental front, I had a breakthrough today.  I think I've kind of been slowing my weightloss on a subconscious level recently for several reasons.  I don't know if I'm mentally "ready" to be at goal.  I know it sounds silly, but I think a part of me just isn't ready to give up everything I've held onto for so long.  Silly, but that's why I'm seeing a therapist I guess.  And I think a part of me is just plain tired.  I don't wanna play anymore.  2 surgeries in less than a year.  Crazy hormones and mood swings... it's a lot to go through.  I'm just trying to take time to honor that and let my subconsious heal b/c on the conscious level, I am very aware that I still have 30 pounds left to lose. 

Enough ranting for tonight.  :P

Well, lol... I stopped the pouch test at the end of Day 3.  I was just feeing too icky and sick with my cold/flu to really abide by the requirements.  I mostly stuck to soup and shakes rather than graduating to firmer protein... I simply have no appetite.  On a positive note though, my pouch test trial has helped me rediscover that "full" feeling and break thwe carb cycle!  I'm feeling pretty positive about it and plan to try it again once I feel better.

Today is a little more tough for me.  I woke up with full-blown cold and flu symptoms this morning... so I am hovering somewhere between not wanting to eat ANYTHING and wanting to stuff myself full of simple carbs.  *Sigh.*  I had the ham and cheese soup for breakfast and am in the process of getting in a TON of liquids.  Hopefully, I can get back on track with lunch and dinner!

Still diuresing, btw.

Well, I've made it through Day 2 of the Pouch Test.  So far, I am pretty freaking amazed.  I have had a few bouts of carb headaches and perhaps some associated mood swings, but overall I feel good.  My energy levels are decent.  I'm not constantly thinking ahead to the next meal or next snack.  It is very much like people comment... like going back to those early post-surgical days.  Although I am looking forward to some solid foods tomorrow.  :)

And I am curious to see what the scale says Monday morning.  :P

Well, I made it through day 1 without incident.  This morning marks the second day of all liquids on the pouch test.  Surprisingly, I feel pretty good.  Minimal carb headaches.  And surprise, surprise- I didn't wake up wanting to nibble on everything in the cabinet.  Pretty cool. 

I've also noticed some pretty significant diuresing taking place; I dont know if this is a side effect of getting back to a more appropriate diet or not.  Hmm... will have to research a bit.

Ok, today was day one of my 5 Day Pouch Test.  I think I did fair.  I had 2 protein shakes- banana chocolate coffee flavored and a cup of soup from Kaye's book- the Ham and Cheese soup.  YUM!  Actually, it was so rich that I could only eat a half-portion of it.  I feel pretty good.  My energy levels are decent.  I am a bit moody and head-achy- I think the carb withdrawal has hit me a bit harder than I anticipated.  All in all, it's not been too terrible though.  (Ok, I need to 'fess up.... I did have a tiny bite of the cheese and ham from my friend's pizza.  Shame on me!)  I nibbled on some apple slices for the card headache and drank some green tea, which helped.  I am also noticing that my appetite is back to the super-low level that I enjoyed immediately after surgery!  I'm feeling quite encouraged.  I don't have access to a scale until Monday, but I am hoping to see some progress!  :)                                                                                                                                                                                                    

i'm horrible at remembering to blog!  seriously.  :P

things have been a bit rough for me the past few months.  my energy levels are quite low; i need to see an endocrinologist but i'm not working often enough for the finances to do so.  i also hit a pretty big depressive slump in march.  the good news is that my mood and my energy levels seem to be on a gradual upswing for the past couple of weeks; i am encouraged by that.

i've also started seeing a therapist for body image issues.  i am pretty depressed and disgusted by the way my body looks after losing 115 pounds in such a short time.  i feel like a melted candle with national geographic boobs.  yeah, cognitively i knew i would face this but it's hitting me much harder on the emotional level.  i feel like i've looked so disgusting for so long that now that i've worked so hard to be a "normal" size i should be able to look sexy and feel confident, right???  well.... i don't.  and it sucks.  i'm working toward plastic surgery but it will be a while before i can afford financing.

speaking of plastics, i'm getting some heinous back pain from those giant saggy boobs!  i've been to multiple doctors and am on muscle relaxers and narcotics... the meds help some but i can't function and i certainly can't work in my job as an icu nurse.  i'm so frustrated.  i need to look into insurance coverage for a reduction.  this is insane!  i saw a chiropractor yesterday and am starting physical therapy next week... i hope it helps! 

sorry to rant so much, but that's my news.

oh, i am also starting the 5 day pouch test today.  my weight loss is slowing down a bit.  i'm officially at 162.5.  so we'll see how this does.  i think i've gotten a little carb addicted and i want to be back on track! 

here's the link if anyone is interested:  http://www.5daypouchtest.com/