9th Month Follow-up

Jan 08, 2009

Wednesday, January 07, 2009

Went to go see Dr. Starr for my 9th month follow-up.  Tracy recorded my weight at 147 as opposed to December 24 when I was 145, I know I wasn't good over the Holidays but I can't seem to shake off the couple of extra weight I managed to put on.  I saw Dr. Starr and he is quite pleased with my progress, he says I'm ahead of target so I'm doing better than expected.  I keep thinking I'm not doing as well as I should be doing so that definitely made me feel better.  I will see Dr. Starr again in March for my 1 year follow-up.

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Counting Down the Days

Feb 24, 2008

 

 on a glittering magic wand

Appointment with Dr. Starr for a consultation.  I was surprised at how young he was I was expecting an older doctor.  He is a sweet man, very polite and cute sense of humor.  I felt very comfortable with him and I liked him.  He agreed to perform the surgery and told me it would take about 1 year and a half, in the meantime I had to do some of my own homework with scheduling appointments.  Tracy from Dr. Starr’s office that if I was willing to pay for Social Services and Dietician I could probably get an appointment before the hospital would give me, so that’s what I did, I paid them myself.  I left the office and made the following appointments.

June 01, 2007

Nutritionist Seminar – August 21, 2007 

Social Services – Shelley Aronov – August 21, 2007

Dr. Starr – follow-up – September 05, 2007 – Dr. Starr gave me the heads up and my surgery was scheduled.  Shelley Aronov recommended the surgery and he told me that the province had approved funding and therefore surgeries were being moved up – yeah I have a date – March 20, 2008

Dietician – Doreen Klar – September 11, 2007

Medical Internist – Dr. Steven Glazer – November 19, 2007

Prescreening at the Hospital – May 14, 2008

Soon after I got a call that I had an appointment with Dr. Lars Klein, well I cancelled it because I was quite happy with Dr. Starr and besides they both work at the same hospital.

 Appointment at Humber River Hospital – Finch Site on August 21, 2007.  It was really informative and very interesting.  The room was full with enthusiastic people and I felt like we were all struggling for the same things, some brought along friends and support partners.  I didn’t think of doing that but I thought that was a great idea, I wish I had brought my husband.  It would have been educational for him to know what my body was being put through with the surgery and what to expect afterwards.

 Appointment with Shelley Aronov August 21, 2007.  I had a very lengthy appointment with Shelley Aronov that took about 1 hour and half.  She’s a really nice person, it was like talking to a friend, and I felt like I’ve known for years.  I felt it went well and she actually told me that she would recommend me for the surgery.  (Whew I was kind of worried).

Tried to enjoy the summer and I think I enjoyed it just a bit too much.  I actually put on weight since my last appointment with Dr. Starr.  He had said that I needed to lose weight before his next visit.  So I started dieting because I knew that I would be seeing him in September. 

Appointment with Dr. Starr September 05, 2007.  I didn’t put on weight, I just stayed the same.  He said it wasn’t bad but I really needed to lose some weight.  And most importantly my surgery was scheduled, which I wasn’t expecting but was really happy.  I assured Tracy I would lose weight.

Appointment with Doreen Klar September 11, 2007.  Had a meeting with her, she was pleasant and she explained what my diet would consist of after the surgery and how important it is to chew your food, the problem with malnutrition, anemic and just what to expect.

Appointment with Dr. Steven Glazer November 19, 2007.  It was a short appointment, his receptionist Lily did an ECG, took down the medications I was taking.  Saw Dr. Glazer and he explained the procedure to me and told me, “you understand that 1 in every 200 patients die, do you still want the procedure?”, and I said “Absolutely”, but in the back of my mind I thought, “Oh my, I really need to talk to Dr. Starr about how many people have died with him as the surgeon”.  Truthfully I wasn’t aware of the stats or maybe I was but kind of blocked it out of my mind.

Appointment with Tracy from Dr. Starr’s office.  Well I didn’t lose any weight so but I promised Tracy I would.  Need to see her after Christmas for a weigh in.

Appointment with Tracey January 15, 2008.  Christmas was great, again a bit too great.  I got a call from Tracy around the second week of January, they wanted to change my appointment to February 08, 2008 and I would need to start Optifast immediately.  I told her I was going away on vacation to the Mayan Riviera and she said that I could start it while I was there.  I didn’t like that idea – imagine being at an all inclusive and drinking shakes 4 times a day.  I started to get stressed out; I know I just couldn’t do it.  So I let the date slip and she told me to go to the office and buy Optifast and start it before my trip and that’s what I did, a week later I went to see her and I had lost 9 pounds.  I was really pleased with that.

February 19, 2008 
Started Optifast I figure it’s a month away I mind as well start it now.

I found this on a of the website, it's a great reminder of what not to do:

Ten Mistakes of RYN

1st Mistake: Not Taking Vitamins, Supplements, or Minerals
Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results. Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include:

Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning.

Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible.

2nd Mistake: Assuming You Have Been Cured of Your Obesity

A “pink cloud” or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it’s hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back.

A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don’t change what you’ve always done, you’re going to keep getting what you’ve always gotten — even after weight loss surgery.

3rd Mistake: Drinking with Meals

Yes, it’s hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.

4th Mistake: Not Eating Right

Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals–don’t skip. Don’t keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren’t as tempted to make a poor choice. And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your “absolutes” based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.

5th Mistake: Not Drinking Enough Water

Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.

6th Mistake: Grazing

Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It’s one thing to eat the three to five small meals you and your doctor agree you need. It’s something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing. Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.

7th Mistake: Not Exercising Regularly

Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!

8th Mistake: Eating the Wrong Carbs (or Eating Too Much)

Let’s face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta–in moderation, of course. (Kamut pasta doesn’t have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as “condiments,” rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.

9th Mistake: Going Back to Drinking Soda

Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS–because when you’re drinking soda, you’re not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.

10th Mistake: Drinking Alcohol

If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it.

Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations.

If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn’t make it any easier, and could make you a lot sicker.

“Dummies” version rewritten by Sally Perez
Original article written by:
Mason. EE, Personal Communication, 1980. Barber. W, Diet al, Brain Stem
Response To Phasic Gastric Distention.
Am J. Physical 1983: 245(2): G242-8 Flanagan, L. Measurement of Functional 
 

February 24, 2008 
I was hoping to have lost 10 pounds at least and it’s not happening, I think I’m down 6 pounds.  I am starving, the weekends are the worst.
 

February 26, 2008
I just got a call from Dr. Starr's office, my surgery for March 20 has been postponed until March 31.  I am so disappointed.  I really liked the original date as it coincided with the long weekend and it was just sooner.  Oh well se la vie.

March 14, 2008
Went to Humber River Regional Hospital today for my PATT.  Not a good day for me.  I believe I'm really tired, I'm trying to get everything at work cleared up before I go for my surgery.  I'm trying to keep up with my course, I finished an assignment and I need to study for an exam for March 23.  Last night I filled out all my paper work for the Hospital, I was trying to be organized.  I went to work for half a day today, then I went home and my husband offered to drive me and pick me up.  When I was three quarter of the way there I realized I forgot my Health Card and Hospital Folder with all the information I diligently filled out the night before....oh crap.  I went to register without my vital info and sent hubby to pick up what I had forgotten.  The receptionist at the hospital was not amused.  Thank God my husband delivered everything before my interview with the nurse.  I had my blood work done, ECG and chest X-ray and a meeting with the Anesthesiologist.  I'm so glad it's done.

March 20, 2008
I got a call from Tracey (Dr. Starr's office), she told that my surgery date is changed ----yeah earlier---.  My new date is Wednesday, March 26 that means 6 days to go.  I am so thrilled.  I cant' wait, I'm just worried that I have to get things moving.

March 25, 2008
Well tomorrow is my surgery, if I didn't say I was scared I'd be lying.  I'm afraid but I know it's what I have to do to get me back on track to a healthier future, I've been ill for too long, I need a firm kick in the backside to get me healthy, and to live again.  The last couple of years have been difficult, my health has robbed my husband and little girl with the simple things in life.  Like just going for a walk, running after her, playing ball.  I'm just sick of it but I'm also afraid of dying - I'm not feeling sorry for me but for my little girl.  She's only 8, she still needs me, like tonight she was worried about what to wear tomorrow, she wears a uniform to school, so I helped her pick out her clothes for tomorrow because it's Civies Day and Friday is Spring Picture day so I helped find something----just in case.  If something were to happen to me I want her to know that she is my world, I couldn't have asked for a better child, she's smart, articulate and sensitive and I have the greatest husband in the world.  He's been my rock, he's made me want to be a better person.  I love them both with all my heart.
 

 

SURGERY DAY, AM I'M REALLY GONNA DO THIS?
March 26, 2008
I've been meaning to update my blog but it's easier said than done.  I had my surgery Wednesday, March 26 at 8:00am.  We arrived at the hospital at 6:25 am (we really should have been there at 6:00 am) but no one complained.  I was immediately called in to register with the nurse, she led me to the bathroom where she handed me a hospital gown and pants (don't bother with the pants I got them up but they were so tight at the legs so I only took the gown.  Then another nurse took down all my personal information, medications, when is the last time I ate or drank anything and then she provided me with a hospital bracelet and back to the waiting area.  Another mail nurse came to retrieve all the patients in the waiting area and escorted us to the basement (I think that's where we were) and there is another waiting area there.  The anesthesiologist came over to introduce himself.  Then not too long after, Dr. Starr was checking in with the receptionist and he looked over and waved me over.  He asked how I was doing and if I had followed the instructions with the Optifast and how I did with it and I replied that yes and I lost approximately 8 pounds in a week and a half.  Then he walked over to my husband and introduced himself.  That was very personable and I really appreciated it. 

 Then I called up by a nurse I believe her name was Sharon and she check all my information and verified that it was all correct and told me that she would be calling me in soon for surgery.   

 A little while later, Nurse Sharon called me, I turned to my husband and gave him a quick kiss; walking away I regretted not saying something memorable to him (just in case).  I walked in the Operating Room everyone was hustling and doing their thing and Nurse Sheila was trying to introduce me.  I jumped up on the operating table and they took my arms, and stretched them out beside me, one was hooked up to a blood pressure cuff and the other they put a needle in left hand for the drip, within a few minutes I started to get really tired and all I remember was them putting the oxygen mask on.  

What seemed like a quick cat nap, I awoke in the recovery room and the first thing I thought was, “Wow, I’m alive!!!”, however I was in a lot of pain.  So I was trying to get someone’s attention, the words “Help me, help me” were trying to come out but all that came out was a mere whisper.  It was like you know that dream where you want to scream but nothing comes out.  All I kept thinking was “What the hell did I do to myself”, I think finally someone noticed I was awake and said, “Oh, she’s awake” and then I passed out again, I think trying to yell out “Help me”, was just too much for me LOL.  

Then I remember being bed wheeled into my room, and I see my husband there just following the bed.  I looked at him and said, “I really need to go to the bathroom”, last time I went was 6:00 am, and it was now 1:30 pm.  So he went to go get a nurse and she said, “Okay, get up” and we’ll help you to the bathroom.  I couldn’t get up, I was in so much pain in my abdomen, that I thought I would burst my incisions or cause damage internally.  So everytime they tried to pull me up by the arms, I would scream, “STOP, it’s killing me”.  So slowly the nurse gave me directions and I finally got out, and she kept yelling at me, “Open your eyes, so you can see where you’re going”.  I was so groggy and kept thinking, but I’m so tired my husband is leading the way, surely he won’t let me fall or bump into anything. Finally made it to the bathroom and my husband’s standing outside the door and I got stage freight, I couldn’t pee, and I was dying of pain, I finally went oh that felt good but I couldn’t help to think, how the hell was I going to get in and out of bed.  

They finally gave me Morphine, but it didn’t really help all I knew what that I felt like crap and thirsty, omg, my mouth was so dry and nasty.  I asked the Nurse Hardon (I referred to her as Nurse Boss, you definitely knew who was boss with her, bless her heart, I really liked her).  Andrea called and I briefly spoke to here telling her about the pain and how dry my mouth was.  My husband went to get me some ice chips to cool my lips, omg, they were too good. Andrea called shortly after and said to request the sponge swabs from the nurse and she brought it over and that was so good too.  

Later my husband left and brought my daughter to visit, she was so frightened, she didn’t realize I wasn’t coming home, and seeing the intervenes and oxygen tubes in my nose freaked her out a bit.  They didn’t stay long and she went home.   

My parents came by, my brother-in-law and sister and niece (I think she got frightened too).  Everyone left and my husband stayed a little longer.  He told me that my friends were all emailing him all day and the phone would not stop ringing that evening.  I love them too.  

That evening, a night nurse came in to check my blood pressure and top up my iv, gave me a shot of Gravel because I really felt nauseous. She was a really nice nurse.   

The next morning Dr. Starr came to see me and told me that everything went excellent; the surgery only took 2.5 hours.   

My husband came by and kept me company; my friends all called and told me I sounded horrible.  I was still not allowed to have anything today, which surprised me because they had Andrea started on clear fluids on the second day after surgery and she was only 1 week ahead of me.  I didn’t question it, as long as I had my ice chips, I was a happy camper, it’s not like I was hungry.  My parents dropped by and my daughter and mother-in-law came by after school.  My parents brought me a beautiful bouquet of flowers, and my daughter got me this cute card (with Simon Cowell) and a CD dedicated to Mothers, the songs are just beautiful.  My friends Tina and Pina wanted to come by but I told them both that I wasn’t in any condition to see visitors, I looked like hell.  Because I was struggling to get in and out of bed and then trying to scope myself up on the bed, I guess my hair was rubbing again the bed sheets.  I looked at myself in the mirror and it looked like I had dreads in my hair and there was hair sticking out from the back of my head.  I tried to put a comb through it because I just looked ridiculous and it was all matted and tangled Ochhhhh.  Oh I forgot to mention the gas pain, omg, it was horrible, and I just kept burping, not huge belches, just quite ones.  It wouldn’t stop, my husband helped me out of bed and I tried to walk around a bit, I thought that would help the gas pain.  

Later that evening, Dr. Starr came by to visit, he wanted to know how I was feeling and told me I could leave tomorrow, at the end of our conversation he asked how I was doing with keeping the fluids down and I told him I hadn’t had any fluids, only ice chips.  Well, he was furious, he went to the nurse’s station and demanded to know why I was not given fluids, those were the instructions he had left, and apparently it wasn’t logged into the computer.  Within minutes a nurse came in carrying to cups of apple juice, which was horrible, I only got ½ of one cup in and went back to my ice chips.  

That evening was horrible, my back was really aching, and the hospital bed was terrible on the back.  I just couldn’t get comfortable; I was up at 4:00 am. Oh, I forgot to mention I had a wailer on my floor, every so often she would start yelling and screaming and crying like a child.  At first I thought it was a child (with very strong lungs) but I was later told that it was a 92 year old woman, who was suffering from Alzheimer but the nurse mentioned that she is a good eater (don’t know why she volunteered that information but she did).  She would sporadically yell, during the day, in the middle of the night, whenever, I really felt for her at first but by the second day, I had enough of the wailer, she was just getting on my nerves.  Needless to say, again I was up at 4:00 am.  

That morning Nurse Boss told me I was going to have my fluids and advised her that Dr. Starr said that I could go home and she said not until she sees how much fluid I can drink.  When my tray arrived it had chicken broth, green Jell-O and tea.  I didn’t do to well in the morning.  At lunch I got the same thing but instead of green Jell-O, it was orange Jell-O.  This time I was able to put down all of the broth.  

My parents came by in the morning and I phoned my husband to tell him that I was getting out today.  I finally got released at 2:30 pm, I was so happy to be going home.  Getting into my SUV was really hard, it was so painful to climb, and the seat seemed so high.  

Then within a fifteen minute car ride I was home sweet home.


April 09, 2008
Had my post appointment with Dr. Starr, he said I'm on target, checked my meds and told me it was okay to start exercising.  I mentioned that the weight isn't coming off as fast as I would have liked and he reminded me that, "This wasn't a race and that slow and steady is better".  I would have liked to have been able to ask a few more questions but his office was extremely busy and besides he got called away for an important phone call.

September 24, 2008
Had my appointment with Denise the nutritionist.  She says I'm doing very well.  I am now losing an average of 2 pounds per week, which is normal since my BMI in considered Overweight and she says it just gets to be a struggle when your BMI is close to normal.  Overall she was pleased with my progress.  I have to say I'm feeling pretty good.

September 25, 2008
I went shopping again...I bought a beautiful Calvin Klein chocolate brown suit...size 8, it's gorgeous, I also bought a pair of Tommy Hilfiger black jeans - petite size 8.  I love my RNY...wish I had done it sooner.

October 04, 2008
Had my 6th month follow-up with Dr. Starr.  Tracy weighed me in and then told me to wait for Dr. Starr within minutes he came into the room and said hello and quickly excused himself.  When he came back he was laughing that he didn't recognize me and got confused when he saw the red folder (only for Gastric Bypass patients).  He is very pleased with my progress and told me I was doing great.  That made me feel a lot better because sometimes I'm not sure I'm doing as good as I could.  I have major stalls all the time.   Then I went home grabbed my husband and went shopping for some new blouses...I'm slowly cleaning out my closet of all my large size clothes...there are clothes with tags still on it, what a shame but how wonderful to feel in size 8.

October 14, 2008
Received a telephone call from the nutritionist regarding my blood work and she says my Iron is low so now I need to take Iron supplements - Ferrous Gluconate 300 mg,  not to be taken along with Calcium (at least 2-hours apart).  Yet another thing to remember to take.

December 29, 2008
Went to see the nutritionist today, Denise Perrier walked by me but it was Sue Ekserci that I saw today.  She was very nice and quite happy with my progress.  Wish I could say the same, I'm pissed because I put on 3 pounds, I think how impressive it would have been if I didn't put on that extra weight.  Sue is pregnat and I won't see her when I go for my next appointment in March 2009.  We also talked about my vitamins, apparently my Vitamin A labs haven't come back yet, apparently they take months because they are sent out...hu who knew.


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