Onward and Downward

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It will be three weeks tomorrow since my surgery, and I'm feeling great!  I meant to post blog postings after my surgery but was posting a lot more in the "What are you eating/doing today" threads in the Ontario forum and neglected updating here.  And the longer I've procrastinated, the longer I knew the post would have to be in order to update...well, I'll bite the bullet now and get caught up so I can post regularly here again without a big gap in the journey.

I think I'm ready to get rid of my pre-op timelines in my OH signature since they take up a lot of space, so maybe I'll stick them in this blog posting, just so that I don't lose track of them completely:

Referral to Bariatric Registry: October 21, 2011     Orientation class at TWH: Feb 22, 2012    
Nurse Practitioner: March 14, 2012                         Social Worker: March 27, 2012
Psycho-Social Assessment: April 3, 2012                 Nutrition Class: April 16, 2012
Nutritionist Assessment: May 4, 2012                     Meeting with Surgeon (Dr. Cyriac): August 17, 2012   
Pre-op Assessment Clinic: October 15, 2012          Starting Optifast: October 17, 2012
Surgery Date: November 7, 2012, Dr. Aarts, Toronto East General

So, the surgery...

It went very well.  I was really nervous (okay, downright scared) before it.  I rushed to get my will done and signed before surgery (morbid, I know).  I was reading a bunch of posts on OH the week or two before surgery where people were talking about some pretty extreme complications they were having.  What I was most worried about is that I would get there and not be able to go through with it.  I was also pretty scared of being put under - the idea that the OR could be the last thing I would ever see was really scary to me.

So my mom came down the night before surgery and she and my husband both encouraged me and made me feel better.  My husband had been doing that all along - he's been amazing during all of this.  I would be fine during the day, but at night around bedtime, all the doubts would choke me, and he would calm me down, reassure me, hug me, tell me it would be okay.

Surgery day came and luckily it was first thing in the morning so I didn't have much time to agonize about it that day.  I had it done at Toronto East General with Dr. Aarts.  I met her on the day of the surgery since Dr. Cyriac did the pre-op surgeon meeting with me.  One thing I really liked at TEGH is that the anaesthesiologist came out and talked to me before they brought me in for the procedure, just so he could introduce himself without the mask on.  It calmed me a lot.  I think Dr. Urbach was there too, assisting Dr. Aarts - he introduced himself in the operating room, but that was a blur for me.  I only realized who he was when he came to my hospital room the next day and introduced himself again.

I was so zoned out after surgery.  It took me about 4 hours in the recovery room because I have sleep apnea so they wanted to keep an eye on me for longer, they said. 

One thing I noticed is that they're a bit stingy with the pain meds.  It seemed to me that they waited for me to ask for them before giving them to me, and the only time I would think to ask for them is when they'd worn off so much that I was actually in pain again.  I didn't like that much - I figure they should know that there is going to be pain, and keep a regular dose going so you don't slip back into pain again before having to have more meds.  So once I was a little more lucid, I found out what the schedule was for meds (a dose of morphine every 4 hours, and then on the second day, up to 2 percocets every 4 hours), and I demanded my pain meds half an hour before they were due so that I wouldn't have to wait in pain for them.  That worked better for me.

That was my only complaint, though - otherwise, my care was absolutely top notch.  The nurses and personal care assistants were extremely friendly, professional, and very helpful. 

I was worried later on in the day after surgery, because we hear about how they'll have us up walking the evening of the surgery.  Well, I wasn't walking anywhere the same day!  I was zoned out, in pain, and I could barely make it to the bathroom myself!  It's the first time in my adult life that I've ever needed someone to wipe me up after going to the washroom, because I just couldn't bend enough to reach.  A little embarrassing, but after giving birth over a decade ago, I pretty much lost all modesty in medical settings! :)

In the middle of the night the first night, I had to get up to go pee several times.  Each time was easier than the last, although I still needed help every time.  Then, the next morning, it was incredible - I got up by myself, went to the washroom myself, and was able to walk around a bit.  It was like a 1000% improvement, overnight! 

I had my period during surgery.  That was pretty special.  And the worst part is that I didn't have to have it. 

My gynecologist got the idea that she could do an endometrial biopsy on me just before the surgery so that I could be under a general anaesthetic for it.  She told me that she made arrangements with Dr. Aarts, that Dr. Aarts had agreed, and so the gyn got me to come into her office to sign a consent a couple of weeks before the surgery.  And she gave me a prescription for a pill that would open my cervix (but also brings on a period) that I had to take at bedtime the night before surgery. 

So, I took the pill and then woke up at 3 a.m. the morning of my surgery with severe period cramps (that's a lovely side effect).  And of course I couldn't take any painkillers for them!  So I got to the hospital, still in pain, and having my period.

I get into the operating room, and Dr. Aarts tells me that my gynecologist didn't send my consent over for the biopsy procedure, and that she would call the gyn (she was on call at the hospital that day) to see whether it would be "feasible" to do both at the same time.  I thought it was all arranged, but it turns out that they had just spoken briefly about possibly doing this, but hadn't completely made arrangements.  That would have been nice for me to know before taking a pill that brought on a heavy period and gave me severe cramps that I couldn't take medication for!

It turned out that they couldn't do it, because it didn't occur to my gynecologist that she would need me to be in a completely different position than Dr. Aarts would - she would need my butt at the edge of the table and my legs up in stirrups, while Dr. Aarts would need me lying straight along the table with my head at one end and my feet at the other.  And they wouldn't be able to move me properly after I was put under.  So they didn't do the biopsy after all.

Other than that little wrinkle, the surgery went really well - it was "textbook" as Dr. Aarts told my husband and mother afterwards.  And it really was!  My incisions have healed perfectly so far - no oozing, no infections, no problems.  And they were stitched up nicely - it looks to me like the scars will be quite minimal.

I've been following the food and exercise plan since surgery and things have been going very well - I've lost 37 lbs so far, since the beginning of Optifast.  But more importantly, I feel much better, I can walk for half an hour now without getting out of breath (although I still get tired after walks), and I'm much more flexible now.

It just keeps getting better and better!  No regrets so far!

Monday morning, Day 20 of Optifast, and two days before surgery!  Just having my morning Optifast and reading OH.

A couple of hours ago, I was home alone at one of my parents' homes.  I was getting a bit hungry, so I wandered into the kitchen, and darned if there wasn't a big bag of tortilla chips there!  So I poured myself a big bowl of them and sat on the couch and started mindlessly eating them.

After eating about half the bowl, I realized - I'm three days away from surgery!  I can't do this!  Oh no, my dream about messing up Optifast is coming true!  Now there might be food in my stomach when they go in!  Damn, damn, damn!  How could I forget??  Should I try to vomit it up?  Should I take a laxative?  Should I just tell them I forgot and made a mistake and hope they don't cancel my surgery?  I was in a panic.

And then - I woke up.  Another one of those dreams!  And this one felt even more real than the last one, because I remembered the last dream IN THIS DREAM!  I was so relieved when the realization dawned on me as I was waking up that I didn't mess up after all.

I can't wait until surgery, if only to stop having these dumb dreams!

And now, a good Opti coping story while AWAKE.  On Saturday night I went to a fundraiser dinner and dance.  I went into more detail about it in this OH thread, so no point in typing it all out again.  But suffice it to say, I went, didn't (ch)eat, focused on dancing and conversation, and had a great time!  And it wasn't anywhere near as hard as I thought it would be - in fact, it wasn't hard at all.  The worry I was feeling beforehand was a lot worse than the reality.  I just planned ahead, drank an opti shake on the way there, brought some OXO powder in case I wanted it while others were eating, and it was pretty much a breeze.

I spent yesterday doing housework at intervals, and also making a birthday card to bring today for someone at work.  So I feel like I accomplished quite a bit.  The house really needed it - I've been in a housekeeping funk and I live with a packrat (to put it mildly), so if I don't keep up on it, then the place looks like a disaster.  Now it isn't quite so disastrous.

Today and tomorrow - training the person who will be temporarily replacing me at work, getting my will signed, going to the drug store to fill a prescription that I didn't get to yesterday, and that I need before surgery, and finishing cleaning the bathroom.  And probably a hundred other things that I can't remember right now.

I'll end by noting: after all these blog posts over the last three weeks, today was the first time I used the tag, "surgery".  Didn't even think of it before.  Not sure what that says about my mindset!

I got home from an evening function tonight.  There was dinner served there around 5:30-6:30, so I brought my Magic Bullet and my Optifast, and I went into a back room with some ice and whizzed some up there, and then went about with my shake as naturally as everyone else was standing around with their paper plates of heavenly-smelling jerk chicken, saffron rice, and Jamaican patties.

Everything went great, I drank my Opti, didn't have any unbearable temptation to eat the food, and socialized just fine.  No one noticed or cared what I was drinking.

But by the time it was time to go home (around 9:15 p.m.) I was ravenous!  I really wanted to get home and make my final Opti for the day!

So I get home by 9:30, rush right into the kitchen, prepare the Optifast and bring it into the living room so I can relax with it.  AND I DROPPED THE CUP AND SPILLED 2/3 OF IT ON THE FLOOR!

I couldn't believe it.  I thought, what the heck do I do now?  I only ordered exactly enough of it, and that's a package, gone!  Will I have to try and order one pouch of it?  I'm always hungry enough to eat all 4 pouches every day.  I read with amazement when people on OH talk about only being able to get 3 shakes a day in.  Seriously?  I'd eat 8 of them if I could.

Anyhow.  So I took a look at what was left in the glass and told myself, okay.  I'm going to suck it up tonight and live with just this little bit that's left as my fourth shake today so that I don't have to put off the pain and deny myself a shake over the next few days, and certainly not the last night before surgery.

So, I've had my third-of-a-shake.  And now I'm going to go to bed so that the hunger won't hit before I get to sleep!  I sure hope I don't end up doing THAT again!

Today is my 14th day on Optifast - I've now finished 2 weeks as of tonight!  But I was not a happy camper today, until my final shake 20 minutes ago...

Superstorm Sandy killed our hydro from 11 p.m. last night until around 5:30 p.m. today.  Which normally wouldn't be so awful, but here's why it sucked.  And yes, I'm keeping in mind that a lot of people have it way, way worse today in areas that were hit really hard by the storm, and certainly am not comparing my very minor complaints with those of people who were hurt, killed, or had major property damage.  But the inconveniences still made me grumpy today.

So first of all, I couldn't use my CPAP machine last night and got a really crummy night's sleep.  My husband also couldn't use his CPAP machine last night, which made it even crummier, because he snores louder than I do! :)  So I woke up exhausted, and was kind of tired all day.

Next - I've gotten to really like Optifast.  That is, Optifast done in a Magic Bullet, with ice and flavour shots.  But because there was still no hydro this morning, I couldn't blend it.  Optifast isn't very good if you can't blend it with lots of ice!  So I took my blender to work and decided to make the shake there.  Got to work, put all the ingredients in the Bullet cup, and then realized that I forgot the BLADE attachment.  Smooth move!

So I asked the folks in the cafeteria to blend it for me as they do at lunch time, but their blender doesn't work as well as my Magic Bullet, unfortunately.  I don't mind that for one shake at lunch, but I've really spoiled myself with the way I like to make my own shakes the rest of the day!

When I got home tonight, the power was still out, and I was mighty hungry and grumpy by that time, so I just put the powder in a glass and stirred it with some water and some ice that was still frozen since we hadn't opened our freezer since the blackout started.  It is not pleasant that way!  Not pleasant at all!

Once I was about a quarter of the way through the shake, the power came back on!  So I tried to blend the rest of it, but it wasn't working as nicely as usual because some of the ice had melted - it just wasn't that perfect consistency that I was used to.  So I added some more ice, and then it was kind of watery and bland.  So that's three shakes that weren't all that great today, for those counting at home!

But finally - finally, I had my fourth shake.  On the way to the kitchen, I passed my husband, who was eating a cheese bagel, and for the first time in days, I had a really unbearable craving for it!  But I resisted, and made my shake.  And I did it perfectly, with Pumpkin Pie SF DV syrup and rum extract for flavouring.  It was so good!

I must have looked like I was in heaven when I sat down with it, because my husband grinned at me and said, "It's good when you're happy!"  That's when I realized that I must have been pretty grumpy when I got home after a day of not-so-great shakes to find no electricity still, and more not-so-great-shakes to look forward to!  I laughed and said, "This is my first really good shake of the day!  When the shakes aren't good, nothing is good!  And when the shakes are good, everything's beautiful!"

We had a laugh over it, but it got me thinking.  On the positive side - I survived a day where my sleep and my food routine was completely messed up, and the food itself was worse than usual - but I still coped pretty well (if a bit grumpily at times), didn't eat anything I wasn't supposed to despite feeling really tempted, and found ways to work around it.

On the "work-on-it" side - I guess I have a way to go before I stop letting food dictate my mood for the day.  I guess it wasn't completely the food, since my sleep was also thrown off, but I guess I have to realize that everything I eat isn't always going to be the most delicious thing in the world.  I have to find a way to live with that without feeling irritable and miserable when I can't have exactly what I want to eat, since I'm never going to be able to go back to comfort eating the way I used to.

Optifast is a breeze for me now.  I'm so used to it!  I'm looking forward to being able to eat real food again after surgery, but honestly, I'm not feeling hungry anymore, and I'm not overwhelmed by cravings or urges.  Every once in a while I'll get a good craving going, but it goes away quickly, and I've learned how to distract myself.

Yesterday, after my appointment downtown, I had no cash on me and had to get some money out of a machine.  I went into a convenience store (something I've been avoiding since being on Opti).  The ATM was right in the middle of all the potato chips and junk food.  I looked at all of the junk and felt nothing.  And was fully conscious of looking at all the junk and feeling nothing and marvelling that I felt nothing.  No overwhelming urges to buy it, no heavy cravings.  I just got my money out of the machine and left, with no problems at all.  It was really strange, because before this Opti stage, I wouldn't have been able to resist grabbing one, or at least having the urge to grab one.

I got wondering - is this how "naturally thin" people feel when they walk into a store?  Do they just not really notice all the junk unless they actually went into the store wanting a snack?  Am I already starting to think like a normal eater in some small way?

What I really want these days is good food.  Scallops pan-seared to perfection on a bed of wilted greens with a few shaved almonds.  Shrimp curry made the way a friend taught me, which is extremely low fat but delicious.

I also have this urge to try experimenting with cooking things with unflavoured protein powder.  What would meatloaf be like if I used protein powder to make it stick together instead of breadcrumbs?  I don't know, but I wouldn't mind giving it a try!  I want to try Eggface's egg bites and other recipes of hers.  I want to try making soups from scratch (something I never do because it never turns out very well).

The great thing is, I'll have 6 weeks off work to recover, so maybe I'll get the energy together to experiment in the kitchen a bit, learn how to feed myself really healthy food cooked from scratch.  It's something I never bothered to do before very much, but I'm looking so forward to starting a new food and cooking life. 

I'm feeling really positive today, I guess!  This weekend has been a breeze, unlike last weekend, my first weekend on Optifast.  This stage has really made me feel confident about the future.

When I woke up this morning, it was from a bad dream.  I dreamed that I messed up on Optifast by unconsciously grabbing an available muffin off a plate and starting to eat the top of it.  And then, after doing that, suddenly remembering that I'm on Optifast and that I'm not supposed to do that, but it was too late to spit it out because I'd already swallowed what I'd eaten.

There were other friends from work around in the dream, and I explained to them that I had just messed up my Optifast, and that I was on auto-pilot when I grabbed the muffin.  I mused about how mindless and automatic it is for me to just grab food and eat it without thinking.

I woke up feeling demoralized, until consciousness set in and I realized - it was just a dream!  I didn't mess up!  I'm doing great! 

Maybe that was my unconscious reaction to completing a whole week on Optifast!  Today is my 8th day.  Now it's pretty routine, and I'm not finding it anywhere near as difficult as I did the first day or two.  I'm not really hungry anymore (what a relief) because I'm being sure to have tea and jello and broth at regular intervals between the shakes.  And I have the shakes at the same time every day.

Today might be a challenge, because the friend I usually have lunch with at work is back from vacation.  I'll just have to tell her that I can't do lunch with her, because even with my optifast shake in hand, it will be unbearable to watch her eating her delicious homemade food.  We'll stick to coffee breaks, which I can handle.

A couple of people at work have told me they can already tell I've lost some weight.  I'm not sure it's that noticeable yet, but they are being supportive and perhaps they're seeing good things because they're expecting to see good things.  The support I've received from friends and family is really great. 

In any case, I can tell I've lost some weight.  I can feel it in my clothes, and I can also see it a bit in the top roll of tummy fat that isn't protruding out quite so far when I sit down!  It's also a lot easier for me to move around, but I credit that to not feeling so bloated from my previous habits of eating until I'm stuffed.

Onto the second week of Optifast!

Day 6 of Optifast - almost a week done!  Hard to believe.  Only two weeks to go after tomorrow!

I was just thinking while reading threads on OH today that my coping mechanisms during the optifast stage could be considered to be a bit antisocial.  I can't see myself eating lunch with people at work over the next couple of weeks because it will be unbearable to watch them eat delicious food.  I'm not going to go out with people to places where I think there is going to be food to tempt me or where I can't control the food environment, or where I might be late for my next optifast shake.

One of my husband's friends occasionally drops in during the evening, and stays until the wee hours.  Eventually, we end up ordering in food.  I've told my husband that if he drops in during these next few weeks, they can't order in pizza or other fast food - they will have to go out and eat it elsewhere.  My husband agrees completely.  (And of course, I won't be accompanying them!)

Yesterday, I cooked brunch for my husband after he was out doing yard work all morning.  It was my way of showing appreciation, especially at a time when the last thing he expected was for me to cook anything for him, and I felt strong enough to do it - it was a spur of the moment thing.  But I couldn't sit with him at the table while he ate it.  I tried to sit with him with my optifast shake, but I just couldn't bear watching him eat those delicious eggs and ham.  So I moved to the living room (we have a small place, so the living room is right next to the dining room) and we chatted across the rooms instead of across the table.  He understood completely.

I know that eventually I'm going to have to learn how to handle food temptation, and learn how to eat my way in a world that eats in a completely different way.  But optifast is such an artificial diet that I know I just can't do it right now.  Once I can eat real food (even the liquid diet looks amazingly good right now, and then I'll be able to have nice soups at least), then I can start learning how to eat my stuff with other people eating their stuff.  Luckily, I'll be off work during the liquid, puree, and part of the soft food stage...

So I'll be social in other ways.  I'll spend breaks with friends from work, sipping tea or broth while they have coffee or tea.  I'll go for walks with my husband instead of sitting at the table with him during meals.  And maybe it's not so bad to stick closer to home on the weekends instead of going out and taking the chance of putting myself in a situation where I can't control myself or the food around me.  It's only for another couple of weeks (or so).

According to Wikipedia, agoraphobia "is an anxiety disorder characterized by anxiety in situations where the sufferer perceives the environment as being difficult to escape or get help. These situations include, but are not limited to, wide-open spaces, as well as uncontrollable social situations such as may be met in shopping malls, airports, and on bridges."

I know there are lots of people who have serious anxiety disorders, and I don't actually have agoraphobia, or any other anxiety disorder.  And I'm not making light of those who do.  But this weekend, my first weekend of Optifast, I've noticed that I'm kind of afraid to leave the house.  I want to leave the house, I want to go and do something.  Yesterday I did go to my physiotherapist without any problem.

But I was nervous doing that, because I knew that I'd had my breakfast Optifast shake at about 7:30 a.m., my appointment was at 9:30, and I knew I'd probably be feeling hungry by then and want a snack, but that I wouldn't be home until around 11ish, which is just before lunch time.  I was really scared at the thought of being in a situation where I couldn't control what food would be at hand.  And nothing that I've been eating as snacks is easily transported, and needs either refrigeration or a microwave to heat it up!

I got hold of myself and just had some Jello before I left - it wasn't a hard problem to solve.  And of course I survived it just fine.  But it was a very real fear.  It kept me inside the rest of the day yesterday (along with the rain).  Well, that and I napped yesterday afternoon because it's hard to have a lot of energy on 900 calories a day!

And now I'm feeling it this morning.  My physiotherapist asked me what my plans were for the weekend, and I told her I wasn't sure - probably sticking close to home on my first weekend of Optifast, because I don't want to be anywhere that I'm going to be tempted by food I can't have, or not have my calorie-free snacks close by in case I get hungry between shakes.  She said, "Hey, you could always go to the movies!"  We looked at each other for a split second after she said that and we both started laughing, realizing at the same time that there was no way I'd survive the buttery popcorn smells for three hours at a movie theatre!

Today, I'm going to ask hubby to go for a walk with me to a cafe that's near TEGH (it's about a 10-15 minute walk from our place, at my pace).  I'll have a tea with sweetener there, chat with him for a while there, and then turn around and go back home.  It'll be a bit of exercise, we'll enjoy the lovely sunshine, and I'll beat this fear of losing control if I leave the house.

Fifth day today - only 16 days to go after this!

Yesterday was my third day on Optifast, and I'm settling into a routine at work.  Optifast in the morning just before I leave for work, another optifast around 11:30 a.m., another one around 4 p.m. a little while before I leave so that I have energy to get home, and then the final one around 7:30 or 8 p.m.  With snacks of jello, broth, and chai tea with sweetener in between.

But now it's the weekend.  No set routine.  No work to distract me all day.  Will I survive?  Of course I will, but I think weekends will be harder than working days.  Although, the nice thing about weekends is that when that exhaustion around 2 or 3 p.m. sets in, I can go have a nap, which is better than desperately missing food.

I'm trying to see Optifast as a bit of a spiritual experience.  Not religious, since I'm an atheist, but definitely a time for meditation and awareness of my body and my hunger signals and my food triggers. 

I used to do really self-destructive things, like come home from work feeling exhausted and eating a bag of chips for supper because they were comforting and I couldn't find the energy to cook anything.  Or go to restaurants and spend way too much money and stuff myself.  I know how to cook, but I only really enjoy doing it once in a while when I feel really inspired and have the energy to do it.

Now, though, on Optifast, I'm actually craving good and healthy real food.  I think about the shrimp curry a friend taught me how to make, and I wish I could go and whip up a batch of it now and eat some.  I fantasize about cooking soups, about all delicious things I could make with some SF flavouring and ricotta.  Hell, I'm even dreaming about cream of wheat right now.

This isn't a bad thing, I don't think.  I like the Optifast, and I look forward to those four servings of it per day.  My favourite flavouring so far that I've come up with is a few drops of almond extract, and a shot of amaretto SF syrup.  A nice combo that tastes good and nutty.  And the nice thing about Opti is that I don't have to think about it - it's simple, doable, and a lot easier not to cheat than with a diet where you have to do more food prep or watch portions.

But I think when the liquid stage comes, it's going to seem like a real treat after three weeks of nothing but Opti, broth, jello and tea!

My first day of Optifast went really well yesterday, even though I had a completely unexpected evening meeting I had to attend right after work.  I thought, uh oh, I'm going to be absolutely starving.

But I wasn't.  Well, I was starving ALL day, really, but not because of my unexpected after work meeting.  I had planned ahead and asked the cafeteria at work to prepare SF jello and my optifast shakes for me.  I brought a whole box of Optifast to work, so I just had an extra package of it around 4 p.m.  I brought a box of Blue Menu broth to work, so I was able to "snack" on that.   So even though I didn't get home until 8:30 p.m., I was just fine.

Today, my second day, should be an even bigger challenge.  Today I have an all-day meeting at a hotel across town from me.  So I won't have a blender available to me (although I should have lots of ice and ice water available), no microwave to heat up my broth, and no fridge to store SF jello (since I won't have a hotel room).

So, today I'll bring two packets of Optifast (just in case the meeting goes late) plus a couple of those little flavouring extract bottles, a few bags of my favourite flavour of tea, and I'll see if I have any bouillon cubes in the house to bring along since the room will likely be equipped with boiling water for tea.

At one point yesterday, I had this overwhelming craving to bite into something.  I had a momentary feeling of panic after that, worried that if I was feeling like that on the first day, how was I going to survive three weeks of this, plus another two weeks of liquid diet after surgery?  I got a hold of myself and told myself that five weeks really isn't that long in the grand scheme of things, and that I can do this.

And now, I'm off to drink my first shake of the second day.