Sara R.

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This weekend was hard. It was payday, the weekend and cold outside. The eating fest trifecta. But i did ok. Saturday i went grocery shopping and bought a lot of low carb foods. meats, cheeses, hummus, celery, lettuce and low carb yogurt, and i cannot forget the cottage cheese i went to 3 stores to find. i splurged and bought a diet cranberry sierra mist. But overall Day 18 Saturday went well. I even went to the theater with my best friend who looooves to eat. She had extra buttery popcorn and was dipping it in cheese sauce. i was prepared though. i brought my premier chocolate shake and drank that throughout the movie. a few times i caught my hand wandering towards the popcorn bowel as a habit of mindless eating but then stopped myself. reminded myself of the hard work of the last 2 days, the surgery complications and the withdrawals of having to start all over again on the preop low carb diet.

On Day 17 i was bored as can be. I tried to read, watch movies and clean but by the afternoon i was having a hard time. my will power was wearing down. my son really wanted some brownies, so i made some and then ate some :( i had enough carbs available to have one, i couldnt stop at one sadly. I ended up having 4 servings of them damn brownies.

Today, Day 16. I got up and packed my lunch. measuring out servings of cheese and egg salad that i made saturday in preparation for the week and other low carb items i bought. i put on make up and dried my hair (havent done for years). and out the door. its monday, the start to the day. it has to be perfect right?! RIGHT?! i called insurance first thing in the morning and sure as shit i was APPROVED!!! on 12/8/11 and apparently there was a letter sent but after talking to the insurance coordinator she has yet to receive the fax. thank goodness i asked for a copy be sent to my work. if you want something done right, you gotta do it yourself lol. the insurance coordinator is an angel, its not her fault, she is taking care of hundreds of patients and all i have is me. I am waiting right now to get that over the fax machine. i have already checked it a million times lol. i can finally get my preop visit with the physician and get my labs drawn... finally!!!!

ok... here is what i plan to eat today:
Breakfast: Carbmasters vanilla chai yogurt
Snack: Lowfat Cottage cheese
Lunch: Egg salad wrapped inside a romaine lettuce leaf and 1/4 c. shredded cheese
Snack: 2 celery stalks and 2 tbsp artichoke, spinach hummus
Dinner: Premier protein shake
Snack: Strawberry Jello

Water: 72oz
Exercise: 30 minute walk around work (up and down hills with stairs)

The brownies made me creep up a few pounds but that just makes me even more strong about not cheating for the next 2 weeks.

Recap: Yesterday was difficult for the first half. I talked alot to 2 of my coworkers who are incredibly supportive. i was so surprised, i almost wanted to cry from joy. i got some good tips of low carb foods that i will pick up tonight or tomorrow morning. I came home and drank my protein shake. my roommate is very supportive as well, he talked with me and helped me clean to keep my mind off food. I love the premier shakes, they help me stay full and taste incredible. I ended up eating everything on my list except the pumpkin seeds, i did not eat all the carrots or ham, just about half of the serving planned.

Today:
Day 19
Breakfast: Danimals Yogurt drink.
Snack: Pumpkin seeds (1/5c)
Lunch: 2oz honey ham
             2 slices tillamook cheddar cheese
             2 tbsp spicey brown mustard
Planned snack: 3 oz carrots
Planned dinner:  Premier chocolate shake

Total 38.5g Carbs/620 Cals

Exercise planned: 30 minute walk around work (up and down hills) and cleaning at home (vacuuming and sweeping.

Water So Far (1pm): 30oz.
Water Planned: 72oz

 Its lunch time and im freaking hungry!!!!! the headache has set in :(

lunch did not help. i am sooo poor its ridiculous :( i cant wait to have a bit more money due to eating less, i pray!

SO far i have stayed on track. its 430 pm and im off work. im headed to the movies to see breaking dawn. im sneaking in my protein shake and carrots! I will succeed! i am strong :)

note to self: get new charger for laptop so i can blog when i am off work for 6 weeks.

I am addicted to blogging now. Im sure no one reads this but it keeps me really accountable and i am able to write anything.

Goal: 30 - 40 carbs
Breakfast: Danimals Yogurt Drink
Snack: 1.5oz carrots
Lunch: 1.5oz honey ham
              2 slices tillamook cheddar
              1 tbsp spicy brown mustard
Exercise: 30 minutes walking up and down hills around my work
Planned Dinner: Premier Protein Shake
Planned Snack: 1/5 cup pumpkin seeds
                              1.5oz carrots
Water: so far - 32oz, planned - 64

Total carbs: 38.5. Total cals: 620.

My official preop diet starts wednesday 12/14 but i thought i could start early, which was fine with my nutritionist. i am glad i did start practicing 1 week early because i would have had a very difficult time and possibly failed. i am also practicing drinking... 30 mins later.... eating... 30 mins later... drinking. so far so good. i neeed that food in my tummy, even if i was thirsty i would still stay away so i could use this food.

Yesterday i tried to start the preop low carb diet but i was not well prepared. I had packed protein rich, healthy foods but i did not look at the carb count until after i ate something from my lunch pail... big mistake! so last night i played around in my calorie counter app (fat secret) and found a combo that would work for me today since i am broke and have to use whatever i have in my cupboard. The above is what i came up with. This morning was hard, i felt a little nauseaus so i ate some carrots which made it worse for a few minutes then helped it subside. there was chocolate in the break room but i said no! no! no! and so far i have followed through. i have 1 hr 20 mins left of this work day. maybe ill be super productive tonight since i cant eat??? we will see.

I received a nice packet of information from the preop diet class that i went to. I am so glad i do not have to do the all liquid diet for 2 weeks! i would be so grumpy and have no energy. I wanted to start today but i am so worried about the withdrawals that i plan to start saturday. my son wont like it but i will be able to nap and lay around all day dealing with the transition.

PRE-OP Guidelines:
2-3 weeks prior to surgery i will need to follow a low carb meal plan to shrink my liver. The reason for this is that the liver holds glycogen, which is 4 parts water. when we do not load up on carbs the water goes away and the glycogen is very small. (or something like that) so the liver turns to a pliable organ like a few peices of paper instead of cardboard. This decreases some risks during surgery because the liver will easily be held out of the way and the entire area will be well visualized. So the low carb recommendation is 30-40 carbs per day! I received 4 pages of items that should be eaten in moderation because 1 small serving has 15 carbs in it. I was not very prepared this morning. i grabbed a lunch like a usually do. trail mix (no candies) but it does have dried cranberries in it. turns out cranberries are very high in carbs. i get to work to see my fave cookies on my desk... mean coworkers lol.. jk! :) so i have a few of those. right now @ 2pm i have eaten almost 100 carbs but only 550 calories. wow... talk about rude awakening. 40 carbs is hard to do! i was totally not expecting that. so tomorrow i will pay even closer attention and try to make choices before i put it in my mouth. so then hopefully by saturday i will be more prepared. i am glad i am not exaclty 2 weeks before surgery because today would be a fail kind of day.

Day of Surgery and the following day --- 12/28-12/29:
Clear liquids ONLY!
-water
-ice chips
-broth
-sugar free gelatin and popsicles
-crystal light
-decaffeinated tea or coffee
-diluted apple or cranberry juice

1 week post op --- 12/30-1/6:
Protein Liquids ONLY!
-protein drinks
-fat free or 1% milk
-reduced, fat free cream soups or blended, strained soups with no particles.
-light, plain or greek yogurt with no fruit peice
-sugar free pudding

2 weeks post op --- 1/7-1/14
puree foods ONLY!
-pates
-hummus
-cottage cheese (small curd)
-melted cheese
-refried beans thinned with broth
-mashed potatoes
-pureed squashes or any other vegetable
-pureed soup and add a dollop of sour crem for flavor
-unsweetened applesauce with cinnamon
-iced fruit puree
-smoothies with protein powder
-pureed chili with melted cheese
-pureed sloppy joe mixture put over mashed potatoes

3 weeks post op --- 1/15-1/29
Mechanical Soft, Mushy ONLY!
-soups (all)
-ground meats in sauces
-flaked or sauteed fish
-tuna or egg salad
-scrambled eggs with mild
-cottage cheese
-casserole dishes (without bread)
-yogurts
-vegetables (only well cooked)
-Crackers
-Toast
-soft cheese
-canned or ripe fruit without the skin
-Deli Meats (no stringy ones like roast beef)
 

My file has been sent to insurance as of 12/2/11. I have high hopes that it comes back this week. Everything was sent to them. My insurance coordinator at the surgeons office is amazing and i have faith that she made it incredibly easy for them to look and say... YES!!! So i have all my family and friends praying, as well as people here on OH that have surgery dates in December that i am friends with. I really hope that they say yes. my life and well being is banking on it.

Upcoming appointments:
12/6/11 Preop diet class.

2 weeks ago i felt like i had a million appts coming up. now there is only one and thats today. I got surgery clearance from my pulmonologist. My sleep apnea is under control. :) i wont get a preop appt with my surgeon yet until i get insurance approval, so that appt with basically be last minute. if i need it at all. the insurance coordinator said i am cleared on their end. i am wondering if i should ask for preop lab work because i would like to know my hct is normal before i bleed out. lol.

it is difficult for me to admit this but i keep thinking i am done with my last meals and then i find something else that i want to eat before the end. and now here i am the day before i start my low carb preop diet and i am scared. my friends and family are pretty supportive and helping me think positively about this next stage. but i am nervous i will fail. i wont though, right?! i am strong and determined! i can do this! its only 3 weeks. 21 days. 504 hrs. and then surgery! my life will change forever, my eating habits will be different. and even though i have done alot of mental and emotional work these past 6 months and even for years before then but after surgery it will be a swift kick in the butt. physically, emotionally and mentally. I am going to be applying for FMLA so i can see my counselor weekly at least for the first 6 months of the year, maybe longer. Yesterday i ate soo much unhealthy food. i could literally see my fingers swell, my toes hurt and my pee is dark. I dont like feeling this way. i want to feel free not confined. tomorrow is going to be a wonderful day filled with low carb choices and lots of water. 

I read a few more articles from one of my nutritionists. there was a statement in there that said... feeling guilty over what you eat only leads to more overeating, not less. This is true! when i look back at how i ate just two weeks ago where i was eating protein rich food and limited my cals to 1200 or so. i felt great. and even if i had a bite of fudge, like i did after thanksgiving, i didnt feel guilty. i was ok with one bite. i actually saved the rest of the peice for later in the day and i found it in my car yesterday. thats two weeks! obviously gross!!! but it amazed me that i only took a bite out of it. i was full of healthy foods and i didnt feel the need to deal with my guilt or mask it by eating the whole peice or more. 

i have learned so much during this process. i am a diet queen. i research and read and try all the time. all the little tricks and tips dont work for me because i dont know the reason behind it. why do i feel this way, is this normal, how do i fix it... like really fix it, not just mask it and trick my brain. my brain is smart, witty and not able to be tricked! thats what i love about this process. i get real answers! 

2 hours until my preop diet class and i think i also get info about my post op diet. very excited and will post as soon as i get the info. This is my accountability page. I will succeed throughout the next 3 weeks. I will NOT be perfect, i will NOT feel guilty, i will give 110% or more into making good food and exercise choices to better myself and get a good headstart.
 

I mentioned at week 6 or so that i wanted to make a list of every reason why i wanted surgery, every reason why i wanted to lose weight and all the reasons why i think my life will be better. I decided to wait until December so in the future i can look back at this blog and easily find this list since i will be having surgery in December

What i am hoping to change:
*Be healthy
*Decrease my worry about Diabetes, High Cholesterol, DVT and other obesity related issue
*Run 1 mile in under 12 minutes
*Wrap a normal size towel all the way around
*Fit in a normal chair without painful awkward positions
*Shop in normal stores
*Stop my feet bones from spreading because of the excess weight they are holding
*Stop using Cpap
*Go Hiking all the time
*Be more socially active
*Buy a winter jacket that will zip up and keep my warm


I want surgery because:
*I am tired of having pain on my upper outer thighs because i dont fit in normal chairs.
*Not have to worry about back boobs or rolling bra straps
*I want my pants to stay up over my belly and butt
*my back hurts
*i cant even do my hair without my shoulders being sore
*i would like to bend over or squat and be able to get up
*i want to be able to ride carnival rides
*fit in an airplane seat
*not have trapped moisture inside my rolls that stink!
*stop stinking because i am so fat!
*I want to live a 'normal' life
*i dont want my son to be ashamed of me
*Decrease the stigma and looks i get when i buy a cookie or bag of chips or sometimes really healthy food
*Exercise outdoors without the insecurities


This is all i can think of because as each minute passes i get more and more sleepy. im surprised i came up with a list like this at all. I will add more as they come up in the comment section :)

1 month and its officially December!!! my house is nicely decorated inside and i hope to get the lights up soon. I will have to coerce my dad or brother to take them down after the new year. I know i will not want to climb up on a ladder just days after surgery, nor will it be safe.

I saw the pulmonologist today for surgery clearance and 1 month cpap f/u. During the sleep study i stopped breathing 5 times per hour. so i started the cpap auto titration therapy. 11/21/11 i turned in my SD card and that showed that i get about 8.5 hours of sleep per night almost every night, i no longer stop breathing and the avg air pressure is 6 mmHg? im not sure exactly how they meaure the air pressure but that looks right lol.

i have my last nutrition visit tomorrow. the goal was to lose 6lbs. i was at goal last saturday but then i started eating out for lunch and boom, my weight this am was fine, 285, only 3 lbs lost in the last 3 weeks but then at the Doctors appt i was 288 again. i am worried that i will be too high tomorrow evening when i weigh in at the nutritionist. i dont know how important the weight loss is to the insurance company but i am officially freaking out!!!! i am now wishing i did not tell a single soul about the surgery because if i dont get it approved by insurance i will be royally screwed. and sad that i cannot have surgery to help change my life.

Upcoming appointments:
12/1/11 Protein Shake Tasting
12/2/11 Last nutrition Visit
12/5/11 Submit to Insurance
12/7/11 Preop Diet Class
12/28/11 Tentative date for surgery

I have not been sleeping very well and have been much busier than in the recent past. Last night i was having a weird 'real life' dream and woke at midnight, soon a call came in from a coworker who needed advice which ended in hurt feeling - on her part - followed by 2hours of laundry and cleaning. not sure what i did that took twoours but i didnt get back in bed until 3am. Up at 7 was difficult because i was having another 'real life' dream. i cannot for the darnest remember what it was but i hope i get back to a restful nights sleep because walking around like a zombie is not working out for me. I stopped taking 150mg/day sertraline about 1.5 weeks ago. and usually i have major withdrawals immediately. I have not experienced any irritability or depression like symptoms except for difficulty staying asleep. I am going to try to stay off the Sertraline but if things get too bad or do turn back into depression i will start back at 50mg/day.

I am slowly starting to collect items for post op. i bought a robe and slippers on black friday as well as some shelf bra tank tops. i have moisturizing chapstick and lots of protein shakes and broth already stocked int he fridge. Very excited and praying hard that insurance reads my case and approves it immediately. by the end of next week 12/9/11. How amazing would that be??!! waiting patiently. ok... not so patiently but waiting nonetheless.

Besides the sleeping issue that has occured the last few nights everything is going exceptionally well. next wednesday i start a 3 week preop diet which i believe is low carb, lean meat and veggie diet. with a clear end in sight i know that i can make it perfectly through the weeks ahead. tomorrow i plan teriyaki as my last and final food funeral. everything else is blah. i am soooo done with food. too bad i need it to live.

I dont remember if i talked about this at week 5 or not. but a nutritionist gave me some articles about emotional eating. i keep hearing in my head, are you hungry and wanting food or are you hungry and wanting something specific. my goal and for the last three weeks something that i have done 70% of the time was eat because i was truly hungry. my stomach felt heavy and empty and i was satisfied with fruit, veggies or soup. there still was emotional/exhausted eating times but not many as you can see with the percentage. and for the most part those times were in the last week.

insurance... insurance... insurance... insurance. That keeps coming up in my head. I am so nervous about getting approved. my life may fall apart if i cant go through with this. i will need some serious counseling. so everyone keep your toes, fingers, and eyes crossed. pray 5 times a day or more and send out all positive thoughts for a quick, flawless, painless approval for the LapSleeve.

Evil?!?!?!

Maybe... in summary its a day where you can eat a ton of food, but isnt that what we do anyways? isnt that why we are here? The holidays are a struggle for people who have issues with quantity control (i.e. ME!) So for me this month and im sure next month isnt so much a struggle about how much or what to eat. i am pre-sleeve so i have some flexability but i am still trying to change my habits. so my struggle is based on tradition. figuring out what is important to me and my son and what we can do without.

all month long i internally fought with myself and was sad that i couldnt afford to buy a bunch of food. no extravagent pies, rolls, candied yams and green bean casserole. at one point i wasnt sure i was going to have money for any food at all and it would be top ramen and eggs for dinner but my dad and roommates came through and we ended up having turkey, stuffing, mashed potatos and gravy and cranberry sauce. pumpkin pie, cool whip and rolls. we had some beer, soda and sparkling cider. for appetizers we had chips and dip and cracked open the last of the pumpkins to roast pumpkin seeds, at the request of my roommate we added cheerios and mini wheats :) it turned out wonderful. the table was full but not excessively so. it was a basic thanksgiving dinner but we all ended up in a turkey coma. we finished off a 14 lb turkey last night between the 6 of us and the 2 dogs. I was quite happy, my family was happy, and we didnt go extravagant. new tradition... minimalistic holidays. less cost, less stress and less weight gain.

Now on to the next holiday... Christmas. I am still struggling with this and im sure, just like thanksgiving i will realize that less is more but not until its over. I always feel guilty not getting everyone presents, spending tons of money and never getting anything in return. I am going to get my son 5 wonderful presents since he is five and 5 cheap presents from the dollar store. Thats it for him. Now for my amazing parents, friends, and coworkers. the doctors i love, teachers my son loves and the dog groomer, hair stylist and mary kay consultant. phew... thats alot of presents and alot of money, money i dont have. i dont want to fall into the american trap of buy, buy, buy. i want to enjoy decorating and little nibbles of holiday treats without excess. i guess that would be the theme of this post... excess. Amercan life is all about excess.

i discussed with my best friend the option to have pics taken on those cute cards and give to people that i care for or who have done something memorable for me and my son with personalized remarks so they know i appreciate them without the guilt of not doing anything or the stress of doing to much. i think this is a great option. also a great way to track my before and after progress. im sure itll end up in the trash and i hate to waste money or make more trash but i want to give back in any way i can. ya know?! any suggestions on what you all have done in the past or plan to do would be greatly appreciated.

Even though some of this post was about things other than my weight or eating habits i think its all tied together. changing these habits and thoughts around how we operate will make the difference in life long, life changing, life style habits. thats important to me. i dont want to go through all this and waste this great opportunity. i know i havent lost alot of weight, but i have changed alot of habits, thought processes and outlook on my future. So EXCITED!!!!!

I have had a quick glimpse of what itll be like pre and post op surgery. I had a sore throat for 4 days before i was diagnosed with strep throat, limiting my intake but not too bad the first 2 days. Then the chills and body aches kicked in along with headache and inability to swallow. This made me think... omg... this is what its going to be like post op from what i hear from people who are already sleeved. They mention something about a spray that wets the mouth??? i am nauseated from being hungry and in pain. and i wondered all weekend what in the world can i eat that wont hurt my throat and make me feel better. I thought forever, mourning the foods i once loved to eat but now hurt me. I then have an epiphany (sp). soft, liquid foods. duh!!! foods that i will have to eat post op. Then i feel much better. just knowing that i can eat something. Soup has been my best friend as well as protein shakes, yogurt and popsicles. I havent made jello or pudding yet because that takes too much work when your sick. Even though it totally sucks having to take care of my house, roommates, dog and child while ill, i am glad that i got to experience pre and post op issues slightly before the actual event. I feel more prepared, emotionally and physically. To me the emotional part is the biggest factor and while i may not have conquered it, i definitely stomped it down and have some control.

Upcoming appointments:
12/1/11 Pulmonologist surgical clearance
12/2/11 Last Nutrition visit, then submit for insurance approval! all fingers and toes crossed. prayers going up and positive thoughts put into the universe :) :) :)
12/7/11 Preop diet class

12/12/11 Praying for insurance approval this day!
12/21/11 hoping for preop surgeons appt
12/28/11 God willing my special day

WOW!!! Closer and closer we go, time never slows, never stops and never speeds up. even though i feel like each week is speeding towards surgery i know that its not. Its much easier to think about eating healthier and losing weight pre surgery when i see that i only have 5 weeks left. its amazing.

I talked to my grandma to verify that she will watch my son after surgery and she has come around. After she got over the shock she is surprisingly supportive. she said 'oooh, that makes sense'! yeah grandma, it does. finally someone gets it. I have yet to ask my dad when he would like to help out but im sure i will get to it once he returns from hawaii mid december. Gosh... i am jealous! i soooo want to go to hawaii. but of course when i am physically able to bike around the island and scuba dive, hike up mountains and do the cool things the islands have to offer. unfortunately i didnt get healthy before my grandparents last visit to the homeland. But one day i will make it.

I bought a house 6 months ago or so and have yet to update my drivers license. call me cheap but i do not want to pay $25 to get a new license until my face is slimmer. It expires next may anyways and i think that will be plenty of time to update my look. i will gladly pay $25 for a new license with a new face :)

since my last nutrition visit 1.5 weeks ago i have lost 4 lbs, mostly because i could not eat for 3 days, or didnt know what to eat. 2 more pounds in the next 1.5weeks to reach nutritions goal before submitting to insurance. eek!!! 1.5 weeks until submission. that thought makes my tummy go wild.

So for the next 3 weeks my nutritionist wants me to practice taking in 1200 calories a day to help lower my weight before my last visit before surgery. Sunday, monday and tuesday was difficult but a heck of alot better than i used to eat. those three days i decreased my intake by about 3-500 calories.

Yesterday 11/16 was amazing! This is what i ate!

FiberOne breakfast bar
Handful of almonds
Small ceasar salad (croutons, ceasar and bacon)
Half ham and cheese sandwich
Pear and pumpkin seeds
Protein shake

I was not exceedingly hungry during the day, when i got hungry i reached into my insulated lunch bag and grabbed a healthy snack. By the end of the night i only had just under 1000 calories. I was amazed, i wasnt longing for anything, i wasnt grumpy. I was actually happy and alert all day but it is under the goal 1200 cals per day. I also only weighed 1 pound different. So then i was concerned that i was not getting enough food so i didnt loose more than a pound. Really a pound in one day is awesome!!! So my mind wandered and today i got to work with a slice of pie on my desk :( So i had pie after the breakfast i had at home, even though i wasnt hungry but wanted to see if a slightly higher intake would help the loss.

So far today this is what i ate.
1 cup frosted mini wheats with 1 cup nonfat milk
1 slice apple pie
 fiber one bar
1/2 serving pumpkin seeds
string cheese
ham and cheese sandwich
ceasar salad (dressing, bacon and croutons)

I didnt even finish my entire sandwich and honestly probably shouldnt even have had it. But i threw away about 1/4 of it. I felt so much like it and still do... 2 hours later. I had a huge bm which slightly helped the nausea. Tomorrow will be better. I think it took a couple focused days on what i ate to really get the hang of it. I dont think i will be eating dinner tonight because of how full i feel. Its icky! and i dont even have the sleeve yet! :) :) :)