A Work in Progress

I’ve journaled since I was a teenager. Recently I read all of the entries from my early 20’s through my early 30’s. It was a big eye opener about the huge (no pun intended) role my weight has played in my life. I know if I still had the spiral notebooks I wrote in as a teenager I could read more of the same. The evolution of my weight problem really saddened me. It was a daily battle in my 20’s and every time I failed at what I thought perfection looked like I berated my entire existence. I tied my entire self-worth to my weight. I realize now that I had no idea what healthy eating looked like. I grew up with a mother that was was either on an extreme diet or bingeing. One week meat was “slowly decaying in our guts” the next we were an Atkins household. We’d go grocery shopping and the next week unopened boxes of Cheerios were being tossed into large black trash bags along with anything else that listed sugar as an ingredient. The very next week we’d spend an evening bingeing on packages of cookies and buckets of ice-cream with jars of hot fudge. At one time or another every group of food was “good” or “bad”. I equated eating “bad” foods with being a bad person. I also learned that I could circumvent that thinking if no one saw me eating it. If there were no witnesses I didn’t have to judge my choices.

Around the time I turned 30 I decided  I’d try to learn to love myself regardless of my weight and that I was sick of the same reel playing in my head day after day when I failed at dieting. I decided no one was going to tell me what or how to eat. I never wanted to hear or use the word ‘diet’ again! I was going to eat what I wanted, when I wanted. I tried to choose what I thought was healthy most of the time but I also did a lot of tuned out eating. Watching tv and eating for hours at a time, to the point of pain most nights. My stomach would get distended, making breathing difficult, as soon as that feeling let up I’d eat again until I felt like one more bite would cause an internal explosion. I never put any thought into why I would do that, it was as much a part of who I was as my eye color or height…something that just was, no amount of contemplation was going to make it different. I didn’t learn to love myself, I became apathetic. I didn’t beat myself up but I didn’t feel good about myself either. Numb, I felt numb.

In 2010 I gained 16 pounds in 5 months. When I went in for my yearly physical and saw the scale I knew I had to wake up and take ownership of this body. The usual labs were done to rule out a medical cause but I knew they’d be normal. I journaled what I ate for 6 days, basically to prove the 16 pounds was a result of not caring and not some thyroid dysfunction or metabolic disorder or an alien invasion of my body. The results were not pretty, 21,459 calories and 1086.5 grams of fat. A knowledge of basic nutrition will tell you that’s how you gain 16 pounds in 5 months. I didn’t know it at the time but that’s when my pre-op period started.  The day after that appointment I joined Weight Watchers. I started working on eating healthy. I was determined to never give up, I realized food was never going away and that this wasn’t a race to the finish but a life-long endeavor.

Three months later I learned what a true struggle was. Witnessing my friends suffer a painful loss inspired me to genuinely participate in my life and to not take anything for granted. Their strength taught me to embrace my abilities and to not hold myself back. I’ve done so much in the last five years that I wouldn’t have ever dreamt I would do.

I had truly hoped that running away traveling would illuminate my path to complete and total health. I’d finally get it all right, I’d win at life. I’d choose to eat healthy 90% of the time, I’d be active, I’d fall in love. Life would be rainbows and butterflies. It didn’t quite happen like that.  I traveled, danced, hiked, went places by myself, made new friends, let go of relationships that were toxic and nurtured the ones that nurtured me back. So many things that made me a better version of my former self. I didn’t let my weight conscously determine what I could and couldn’t do but it was dimininshing my experiences.

Last winter was a reawakening for me. I was in a location I loved and yet I was still depressed. It was hard to accept that the apathetic feelings were not a result of where I was or who I was with, they were deeply ingrained in me. Changing my surroundings was never going to cure how I felt about myself. I needed to change myself. Inside and out. I needed to try to make them match. I could feel whole on the inside then look in the mirror and only see brokeness. Or see my outward beauty but feel empty inside. Really, that whole concept could turn into a book. The rare times I accepted myself physically I really just felt pissed that I didn’t have everything I wanted out of life and would end up blaming it on my physical appearance. Vicious fucking cycle.

Anyway, last winter I felt more lonely than I ever had and I wondered what the Universe’s purpose was for me being where I was, over 1,000 miles away from the people who knew and loved me most? And that is how the idea of weight loss surgery escalated from just a blip on my radar to a reality.

I was never more right than when I realized weight and food issues were a journey not a destination. I feel fortunate (and rather extra intelligent) for realizing that WLS was not going to conclude that journey. It detoured the route making it difficult to persist along previously trodden paths. Not impossible but difficult.

It’s almost been 5 months since I had surgery. I’m trying to use the honeymoon phase to my advantage by working on looking at food through new eyes. It is difficult to shed the ingrained patterns of the past, more so when the people who share the same surgical experience have completely different objectives. So many WLS patients have been told, or turn what they’ve been taught into “Carbs are the anti-Christ” The first time I was at a support group and mentioned that I had a half of 100% whole wheat sandwich thin you would have thought I had just said I licked a toilet seat. The looks of horror and disbelief made me feel like a two-headed monster. I routinely hear and read, “I haven’t eaten carbs since surgery…six months, a year, two years ago” That may be the reality they are willing to live, I’m not. Initially I let their opinions make me anxious about my choices. As usual some clarity came to me while hiking, my goal is to make healthy choices 90% of the time and not let the other 10% derail or define me. There is evidence, anecdotal or scientific, to support any diet…from Gluten Free to Grapefruit. There is not ONE diet that will work for every body. I need to discover what works for me and me alone and not worry about what everyone else is doing. 90/10 has been my ultimate goal for the last 7 years. I want a healthier relationship with food. For me that means somewhere between my past where I’d eat a half a pan of brownies in one sitting and feel nothing about it and my present where one single brownie had me reeling in guilt and unforgiveness for days.  I trust that I will get there.

Overall things have been going well since my last post. I’m still avoiding counting on the scale for positive feedback. By the end of June I had lost 60 pounds and over 32 inches. As of July 28 I was down 70 pounds.

My blood pressure at my yearly physical was 104/68 and my non-fasting blood sugar was 74. Last year I was on blood pressure medication and my readings were routinely 130’s/80’s and my fasting blood sugar was 109. All of my labs, including vitamin levels, are perfect.

Hiking 70 pounds lighter is amazing. I’ve hiked double digit miles several times and could have hiked longer.

I no longer have daily foot or knee pain.

I didn’t need a seat belt extender when I flew.

Last night I sat on the ground for a concert and was easily able to get up more than 3 hours later.

I can no longer wear 3X/size 26/28 unless I want to look like a clown. On the downside finding clothes that fit as comfortably as my well worn jeans did proves difficult. I can pull size 20’s off without unbuttoning them but size 18’s are too tight. I know…wah!

I can see knuckles in my hands every day.

The tendons in my feet and hands are visible.

I have ankles.

I used to love store made cookies, Snickers, Ice cream…I’ve tried them since surgery and they just aren’t as good as I remember. I can eat more grams of sugar (processed or from fruit) without repercussion than many of my cohorts so I need to navigate this avenue with care.

It’s not all sunshine. My hair is falling out in clumps, the skin on my neck looks like a turkey waddle, I have more energy but when I’m tired I’m exhausted in a whole new way. I’m less tolerant of milk. It doesn’t take much to overeat causing my stomach to hurt worse than any time in my past, the amount that causes this changes depending on the combination of food, time of day, how much I chew, etc.  None of this surprises me but there is a learning curve to be sure.

I would 100% recommend surgery to anyone that is willing to put in the psychological and physical work to maintain the loss. I work with a personal trainer twice a week and a therapist once a week. I document everything I eat, every day. I don’t see a future where I don’t do these things if I plan to get to goal and maintain it. It’s just part of my journey now.

progress august

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Afternoon Randomness

I want to say thank you to everyone who has asked me how I am feeling. Your support has been amazing and means the world to me.

I was feeling like I hadn’t worked back up to my pre-op energy level but during a discussion with my dietician I realized that it is more likely that I don’t have the amount of energy I expected to have at this weight. In the past that extra energy came from a sustained increase in my activity over the several months it took to lose the same amount of weight. This time I went through two surgeries and a medically induced starvation mode, I can’t expect to ready to run a 5K.  I go back to work tomorrow. I’m as ready as I’ll ever be. Ideally being back will get my schedule on a routine, instead of falling asleep anywhere from 10pm-2am and waking up between 7am and 10am.

I haven’t had any complications since I’ve been home. No vomiting. Nausea twice when I either ate too fast or too much. It’s a learning process. The worst issue I’ve had has been constipation. I had abdominal pain and tenderness for 5 days but was due to see my surgeon so I just waited it out. The discussion started with possible gall bladder issues, ahh hell no, but turned towards constipation being the culprit. I stopped for some good ole’ Milk of Magnesia on the way home. Word from the wise, do not get the original flavor…it nasty. I prepped my bathroom with reading materials, baby wipes and a cell phone charger just in case I needed to put in overtime. I slugged down some white chalky nastiness and waited. It wasn’t easy but the job got done. I have irrational fears of two things: Birds and Constipation. After needing a rectal fistula surgically repaired in 2010 I’ve come to appreciate my history of unpredictable diarrhea. Now I need to navigate my way to regularity through pharmaceuticals. Hopefully it doesn’t take me long to find the fine line between anal tears and sneeze induced back end accidents.

The only other aspect I’m finding problematic is numbers. As in trying not to focus on them but finding it somewhat difficult. In the past I’ve let the scale dictate how well I was doing. When the scale stopped moving I’d end up quitting. The last time I lost weight I tried not to focus on the scale, only weighing weekly, but found the inquiries of “How much have you lost now?” became difficult when I plateaued and no longer had a new number to report. Over time the compliments felt unearned because the number wasn’t changing. I felt better. My clothes were getting looser but because that damn scale needle wasn’t descending I became discouraged. It’s very much a head game. I went into this aware of that. I talked to some co-workers about what they could do or not do that would help. I thought requesting that people not make weight related comments would be helpful. I’m finding that weight loss is a frustrating endeavor tied to a bunch of experiences and emotions. Regardless of what the scale says or what other people say or believe about me what I say or believe about myself is going to determine my success. When someone says, “Looking good” I need to hear just that instead of adding “but not good enough”.

But that scale, boy does she hold some power. When the scale didn’t move from week 2 to week 3 I was disappointed. Who gets disappointed with a 29 pound loss in 3 weeks? It didn’t matter that I had read that a several week plateau around that time would be normal. It didn’t matter that my surgeon praised me for an excellent job. It didn’t matter that my dietician reassured me and informed me that I was expected to only lose 2 more pounds in the next week to stay on track,  a 10% loss in the first month is average. I was disappointed. I was frustrated that I was disappointed. Then I remembered I wasn’t going to let a machine ruin this experience for me.

Instead of focusing on not feeling any lighter, or any other negative thought, I started recognizing and acknowledging other changes.

-Instead of the bottom 1/3 of my bath towel gaping open it now overlaps by about 3 inches

-My shoulders are more narrow evidenced by the neckline falling off my shoulder on many shirts and so much so on one shirt that I found my breast hanging out at Starbucks.

-I was able to lower my steering wheel one notch. Before I had to raise it to fit my belly behind it. The steering wheel was in my line of vision. Now it’s not and I can put one hand on top of the other over my stomach and I’m still not touching the steering wheel.

-Max has a lap to sit on. He no longer has to lay on my belly or boobs, sometimes he still chooses to do so.

-I just cut off 6 inches from the pool noodle that I fashioned into lapdesk because my lap wasn’t long enough for a store bought one.

-My seatbelt is no longer extended so far that it hangs out the door when I take it off.

I haven’t owned a scale for over 20 years, I don’t ever intend to buy one. The numbers are nice to know, especially when my original jeans still fit, but I think overall not being able to use one to judge my daily progress is the right choice for me.

This week I was released to do everything but sit-ups/crunches (aww shucks) I joined a gym and signed up for 25 personal training sessions. I cancelled my Netflix subscription. I’m ready to take full advantage of this “honeymoon period”. I’m ready to be the changes I want to see or at least fake it til I make it!

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Hospital Shenanigans

I have a long-standing medical history of That Would Only Happen To You. I guess it started as early as 5th grade when I broke my ring finger during a morning gym class. The tip of my finger was bent back, touching somewhere between my first and second knuckle. I was given an ice pack and told to return to class.  As an adult; I went in for a UTI and left with a lightbulb burn to my taint. A skin flap on my heel was painfully sutured only to fall off in my shoe a week later. I was seen for chest pain and then taken to Ultrasound for pain in my upper leg, turned out that my wide rear-end pushed the metal sides of the wheelchair against the spinning wheels, causing friction, heat and a burning sensation on my leg. I could go on (and on) but you get the picture.  I’ve come to assume something odd will happen when I enter a hospital as a patient,  I always hold out hope there will come a time when I outgrow this phenomenon. Weight loss surgery was not to be that time.

Everything leading up to surgery happened very quickly at the end and was a roller coaster ride. I was approved by insurance on February 20th and made a tentative surgery date for March 17th on February 24th while I worked with my manager for approved time off. I got final approval on March 3rd.

I told my daughter, The Kid (TK), about my plans to have surgery back in October, she insisted that she be here for the surgery and staying about a week after to help me recover. I was hesitant based on her attitude and lack of helpfulness after my last surgery but after reminding myself that we were both in different places in our lives than 3 years ago I quickly accepted her offer with gratitude. I had been told at the end of January that approval can happen very quickly and could expect a surgery date 3-5 weeks after submission. Poor TK cleared and uncleared her schedule several times before the big OK came in but once it did I booked her a flight to arrive the Saturday before surgery.  I was scheduled to work until 7:30 and her flight arrived at 7:40 and was a 40 minute drive from work, thanks to a great co-worker that was willing to cover for me and to a slower than normal day on the floor I got to leave work around 1:30. I decided to surprise TK and meet her inside the airport, normally I’m lazy and do a drive-by pick-up. I looked on the board to see where her luggage would arrive and waited for her to get there. I snuck up behind her when she was trying to find which carousel she needed to go to. I told her which one it was and we walked there, of course at the complete opposite end from where I had parked. No one else was there so we took some seats and waited. We gushed over each other and had some laughs. I got so excited at one point, messing up my words, that she exclaimed that I “forgot how to English” which made us giggle even more. We talked about how hungry we were and decided where to eat. Then we realized that it was odd that no other passengers were waiting for their bags. We had sat at the wrong carousel for more than 20 minutes. So typically us. At the car we found a big, shiny Escalade had parked like a jackass, with its back-end angled into my spot by at least 4 inches. I was hungry and willing to take my chances of clipping their back-end, hell I didn’t care if I knocked the bumper off.

Pre-op diets for weight loss surgery (WLS) vary by physician.  Anywhere from a two-week liver shrinking diet to 24 hours of clear liquids. My surgeon instructed me to eat normal until the day before surgery and then clear liquids the day before and a whole bottle of Magnesium Citrate at 5pm. I fought the temptation to give in to The Last Supper mentality  for the 3 weeks that I waited for surgery day. I did awesome. I had pizza and taco dip and a few other things but I didn’t binge on them. Well, I ate more than a skinny girl could but I must have eaten less than the 2,700 calories it took to maintain my weight because I lost 6 pounds in that time. I knew all along that my last unhealthy meal was going to be ribeye and some absolutely delicious dessert. I was torn between

Whole Foods Berry Chantilly Cake

or The Kitchen’s Sticky Toffee Pudding

Both orgasmically good. Sunday was my last day to eat solid foods for the next 6 weeks and my last chance to eat more than a half a cup of food at a time forever. All fight to not Pig Out was gone. And as unhealthy and possibly sick minded as this sounds I was glad to have TK with me. Maybe it’s because I knew that no matter what or how much I ate she would not judge. Also, I knew that my dedication to pigging out would not influence her to do the same so I didn’t have to feel guilty on that account either. We made bacon and French Toast using Rubicon Cinnamon Bread, oh I wish I had taken pictures it is so good and there are too many people who don’t have access to Whole Foods.  We like peanut butter and syrup on our French Toast, as I fried a second panful TK made hers up and as she took a bite I turned around and noticed that she had used Max’s peanut butter. I tried making it ok by saying that I don’t usually double dip after putting it in his Kong and I was sure that it was fine. No go, she spit it out and dumped it but not without feeling bad for wasting. Hell, we had a whole other half a loaf that wasn’t going to get used so no problem. I sure wasn’t going to be willing to share my portion.

After breakfast we went to Target for a little pre-op shopping.  We I had decided to put a little more time between our my huge breakfast and dinner by going to a movie, Kingsman: The Secret Service, good movie, great popcorn. Then we stopped at Whole Foods for my cake. When I had called ahead they had single servings or one 10″ triple layer, I reserved the 10″ of course. Wow, a 10″ cake is much bigger than a 10″ pizza, must be the triple layers. I thought of the travesty if I dropped the cake and then decided I could not fool myself, I’d scrape up whatever hadn’t actually touched the ground and carry on as if I were normal. My balance was impeccable, also I protected it like it was a football and I was in the Super Bowl.

I chose Saltgrass Steakhouse for my “last supper”. I ordered the small ribeye with grilled shrimp, hoping not to have any leftovers. A house salad with their homemade Ranch and a loaded baked potato. We shared the Lemon Pepper zucchini strips. It was all delicious. I had about half of my steak leftover and was happy to have that last bit of fatty yumminess to inhale just before midnight. I was full, maybe too full, when we left so I was thankful that we had decided on an early dinner so that I still had time to devour cake. I did want to devour it too. There was no knowing how I would tolerate sugar after surgery and may only tolerate a few bites of such a decadent dessert in the future before wanting or rather needing to toss my cookies. When we got home I showed TK a video on what to expect after surgery and one on the actual procedure, in cartoon format as not to gross her out. Then I got caught searching images of post WLS loose skin. TK reassured me that it would be better than dying from high blood pressure and that it was going to allow me to do longer hikes. I chose a few images that I thought might resemble me at goal and came to terms with them. Then we ate cake!  After she went to bed I demolished 1/4 of the cake in search of more fruit and then put it away after completely and utterly gorging myself. Right before bed I drank a cup of Smooth Move tea in hopes of giving my body a head start to the Mag Citrate. I woke up and had my normal poo. I was dissatisfied but there was nothing I could do as I had planned afternoon massages to break up my clear liquid day. TK dropped me off after our massages so that I could guzzle Magnesium Citrate while she dropped The Pooch off with my friend. I was concerned about drinking a whole bottle that late in the evening. My surgeon’s nurse, who was also the WLS support group leader when I started in October, happened to call to confirm my surgery time so I asked her about it. Apparently my surgeon doesn’t always prescribe this, he must think I’m full of shit, so she told me to call him. I had already called him on Saturday because my belly button was red and funky. I felt bad but remembering that I tell patient’s that is part of what they get paid for I did. I had to leave a message and was worried he wouldn’t get back to me so I slammed it down. About an hour later I ate jello which forcefully came back up right as TK settled in to eat her supper. My surgeon called and I told him that not only did I not have any results I had vomited at least half of it back up. I figured that seeing this was not routine pre-op for him it wouldn’t matter and he reassured me that it was ok and that I’d still have results. I kept waiting for the telltale gurgling and lower belly cramping but nada by 11pm so I went to bed, assuming I’d be woken by it. Nope. My alarm went off at 3:30 and nothing. I had a small BM just before leaving the house and another just as we arrived at the hospital but certainly not enough to cover the smorgasbord I’d consumed the day before. I was soooooo worried that he was going to cancel surgery. I harped on it to TK. I told the aid that called my name from the waiting room. I mentioned it to the nurse before she could get my name and date of birth. Nobody else was as worried as I was. Not even the housekeeper. My nurses proceeded to get me ready. I had one more liquid BM when I gave my urine sample so I refused to take my underwear off, not wanting to leave skid marks on the bed sheets. Of course once I was found out I was given a pair of mesh panties instead. Not even the nice ones, they were the once that had holes more like a colander that elbow macaroni could slip through, and a size too small. I considered folding them in quarters and slipping them between my cheeks but decided against it when I thought how awkward of a discovery that would be for whomever was placing my foley catheter. My surgeon came in and the first thing I said was,  “I barely had results, I’m most certainly still full of shit, can you still do the surgery, will everything be ok?” He said yes, gave me a reassuring look and left. I was not reassured. Visions of abdominal cavities full of feces ran all through my head. My anesthesiologist came to see me . I asked how he felt about a little Versed and he was on board with that plan, it was hard for me not to fall in love with him right then and there. I got wheeled into the OR at 7:30am just as planned, and that is all I remember until several hours later. Thank you Versed!

What I write from here on out is a combination of memory and possible hallucination. Thank you anesthesia!

I woke up to nausea and pain but mostly nausea. I heard someone say, “It’s almost 1:30. She needs to come up to you.” I assume I was in recovery a little longer than normal. In the past I have had vague memories of the recovery room. That is my only memory and then I was being wheeled “upstairs”.

I remember asking repeatedly how long it had been since surgery because my instructions said I’d have to walk every four hours after recovery. Every time it felt like the first four hours should be up I would ask, I must have asked or thought about asking 40 times before it was finally four hours. You may be asking yourself, if you felt like walking sooner why didn’t you? I didn’t feel like doing anything besides puking or dying but I was going to follow “The Rules” I had been given. I remember walking once around 7:30. I pushed my Dilaudid PCA (patient controlled analgesia-the give yourself your own damn pain medication machine) button routinely to the point I was certain I would OD, I don’t remember having that much pain to do so just an instinct that I should. I requested anti-nausea meds around the clock and nothing seemed to help. It felt like the Foley balloon was ready to fall out and like I had to pee constantly, I knew that I needed to be able to get up for it to be removed so I got out of bed several times to “pee” and begged for it to come out before midnight. They obliged. What a fucking relief! I got my period. Through the night every time I twisted to the right I got this terrible, searing pain in my left upper quadrant. My left mid-back ached constantly. I had the worst, most painful heartburn of my life. I was pretty miserable.

The next morning, Wednesday, the surgeon’s nurse stopped in. Everything is pretty hazy except that I was yelling because of the pain I was having trying to get out of bed. When she asked how I was doing I think I screamed something like, “I just want to get out of this fucking bed” I saw the look of shock/hurt on her face. I had gotten to know her before surgery through the support group. I went every month from October through March, we had talked on the phone, I saw her for pre-op appointments. This was not normal for me. She later told me that she had thought, without any doubt, that I’d be the kind of person to sail right through surgery so she was definitely shocked when she saw how much pain I was in. An explanation for that pain would come later.

When the surgeon came to see me he told me that he had discovered a very large hiatal hernia. He explained that most are the small, his hand indicating the size of a quarter. Apparently a portion of my stomach the size of a baseball, again indicated by how he held his hands, had come through the hiatal opening and was pushing against my heart. He told me the majority of the work he did was on the left upper side and that pain there was normal. He was also optimistic about the fact that although I was extremely nauseous I hadn’t actually vomited. We talked about possible discharge the next day or maybe Friday.

I walked. I requested that my PCA be taken away, suspecting that was the cause of some of the nausea. I sipped my fluids through the nausea. I hoped that I’d be going home the next day. I started feeling better once the Dilaudid left my system. IV Tylenol and IV Toradol are miracle drugs. TK took charge of unplugging my IV, unhooking my SCD’s (Sequential Compression Devicesthe pumping leg warmers that prevent blood clots) and helping me out of bed and reverse getting back in. She had brought the laptop to watch Scandal while I rested. I’d be willing to bet she didn’t get through a whole episode all day because of my interruptions. She never acted exasperated or complained. (Lol, I was just going through my texts and found one from TK to The Fiancé saying she slept 4 hours in the first two days after my surgery. See, I had her running.)

That evening the nausea turned to vomiting. No ordinary vomit for this girl though. Gross blood with clots. The first time it happened I just couldn’t fight the nausea any longer and I screamed for TK to “GET THE BUCKET GET THE BUCKET”  when a large amount of bright red blood came out she stepped back and covered her mouth with both hands. Her eyes said it all, it was horrifying. In all of my uncoolness I yelled at her for just standing there and told her to push the call light in between gagging on the clots that were still coming up. I was a little over 24 hours out from surgery and had maybe 100 cc of fluids including water, ice chips and tea. Everything was definitely out of me and none of what I had consumed had red dye in it. It was important to me then to make sure EVERYONE knew that so I thought I should make sure you did too.

The next morning, Thursday, we were walking in the halls  and I felt better. We passed my nurse and her student and I heard the student ask if my hot was still running. I had joked about feeling so hot and sexy during the night after vomiting. I danced and shimmied around my IV pole and said “I’m always hot, Tssss” TK looked at me mortified and knowing that I always hear things wrong asked what I thought she said then informed me that she had really said, “At least you are walking” Not even embarrassed, I made two people laugh, it was worth it.

My surgeon saw me in the hall and asked how I had done through the night. I told him that I had thrown up blood a couple of times and that the pain in my left side was worse when I twisted to the right, which I had to do every time I peed to wipe. He told me, “Spitting up a little pink froth is normal” , I could have a little bleeding from the staple line” That was the first time I did not feel listened to by him. I was pissed. And I started documenting the amounts and times and made sure a nurse saw every bucket of puke. It was about 150 cc during the day and all of my earlier complaints continued to get worse. I was so obviously not going home that day.

TK and I repeated the day before. Walking, sipping, un-hooking, unplugging, re-hooking, re-plugging repeat, repeat, repeat!!! Interspersed with IV medications for nausea and pain, add a little Carafate (stomach coating medication) and Pepcid. The ray of light in my day was that I had diarrhea a few times. I was certain that it was finally the Mag Citrate working because it was like my insides were exploding out of me. It hurt so bad to turn to wipe. I tried to turn to the left but my left hand is useless. I am not ambidextrous. At all.  And the mess I made. Worse than a few skid marks on the bottom of the toilet bowl. Think barn stall door. I think this caused my second hospital break down. I’ve always said if I can’t wipe myself I’d rather die. Man, I am so glad that some higher being knows better than me. I could not see the tempory-ness of my situation and started sobbing. Why do nurses have an uncanny ability to walk in right in the middle of a melt down? I was told to call for help the next time. Of course I had to try to take care of it myself one more time but after more sobbing I pulled the call light and waited in my humiliation for help to arrive. It wasn’t as bad as I had built up in my mind. And I was never more thankful for housekeeping than at that moment. Bless their hearts. Oh Lord, I’m remembering the first three days, when I couldn’t wipe from the back while seated so I made TK stand next to me for support while I hoisted my leg up on the edge of the toilet and contorted in a way that didn’t cause pain to get my area wiped dry after peeing. Too bad I wasn’t in a humorous mood or I would have asked if she could feel the steam heat from my undercarriage? Bwahahaha!!

I’d gone 8 hours without vomiting. The nausea had gotten better. Two of my friends came to see me. We visited for about an hour. The surgeon came to see me and  continued to reassure me that it was probably staple line bleeding, it needed time to heal and he would not send me home until it was.

My new nurse came to introduce herself as my friends were getting ready to leave and she no sooner stepped out of the room when I threw up another 125 cc of blood.  It was preceded by horrendously bad acid reflux. I got the Pepcid and Zofran and slept for a while. I got up to the bathroom and to walk several times that night. I had another blood emesis right before change of shift.

Severe nausea set in around mid morning on Friday and I vomited every 3-4 hours until mid-afternoon. Always blood, always clots. I don’t know that I’ll ever forget how throwing up warm, clotted blood felt or how it tasted. I was exhausted, I didn’t even care enough to brush my teeth.  I had a six hour break from vomiting but then I had almost 200 cc. My surgeon got called and I got an order for Ativan, as a latch ditch effort to help the nausea they said. I knew they just wanted to keep me quiet for one fucking minute. And it did. I crawled into bed and finally slept for more than 30 minutes.  The nausea returned with a vengeance in the middle of the night. I had an affinity for the QueaseEASE, individual  packets of aromatic essential oils that calm  queasiness when inhaled, but the pocketful I’d accumulated had lost their power. I started safety pinning my gown closed days earlier because I’m shy like that and prefer my boobs inside my gown, I decided and pinned a QueaseEASE to myself; I received many comments on my ingenuity. I could have stuffed one up each nostril and chewed on a third, I knew that once my mouth started watering an emesis was on its way. At least a full 7 hours had passed.

On Saturday my original IV infiltrated. My lesson from that is, when your patient complains that it is hurting every time you push meds change the site immediately. It has been almost three weeks and my hand and wrist still hurt to the touch. They put one in the opposite forearm that infiltrated almost immediately. Then one was placed in my hand and within a few hours it was leaking at the site. The connections were tightened  and the site re-taped but it kept leaking. I lifted the tape and saw that it was actually leaking between the catheter and my skin, like there was a gap. The infusion nurse was called and came with her handy-dandy ultrasound and easily inserted a new IV in my forearm.  I had  slowed down on my sipping and the vomiting slowed down to about every 7-9 hours.  I coddled that IV site, because I was depending on it for hydration. Looking back it seems that for every 60 cc I’d sip I’d throw up about 125. Even when it took me 12 hours to get that amount in. It was always thick and bloody so I never considered that very little to nothing was getting past my new pouch.

The surgeon came that evening. He asked if I had bled heavily during childbirth, of course I had. He started considering a bleeding disorder because he had stopped the Lovenox Thursday and I was still vomming blood.  He told me that if it continued he’d investigate that theory further; he encouraged me to try drinking. The nausea continued, and the GERD, omg the GERD. It was always worse right before vomiting. My day nurse had asked the for a Protonix order. We made a plan that I’d take Protonix and Pepcid along with Ativan, Tylenol and Toradol before bed. After five days in the hospital I just wanted to sleep. I started feeling much better and walking more. The last time I had gotten sick was early Saturday afternoon. I felt like I could drink something and hot cocoa was the only thing that sounded good. My nurse hunted down a packet of sugar-free hot cocoa, the first few sips tasted good. Then it started tasting like a glass of salt water. TK agreed that it tasted salty. My new found appetite was gone.  The GERD started right after change of shift. I waited because all of my previous nurses had come and introduced themselves within the first hour of their shift, I assumed I’d see my nurse by 8pm. I finally put my call light on at 8:15. The worst CNA in the world answered it. I swear she picked up extra hours during my stay, she was there more than anyone else. Anytime I’d ask for something she’d either just smile, nod and never bring it or respond with something completely different or ask why I needed it. I told her that I needed my nurse asap. An hour later I had to call for her again. This time the nurse responded. She walked in the room, didn’t introduce herself or acknowledge that I had called and said, and this is a direct quote, “I know you were expecting to get Dilaudid, Compazine and Ativan all at the same time” I cut her off and clarified the plan I had made with my day nurse and corrected her assumption that I was taking narcotics around the clock. I made it very clear that I didn’t think I was getting those medications, I was getting them. She huffed, rolled her eyes and asked if I had been doing my Incentive Spirometry. I confirmed I had been as TK reached down next to the chair she was sitting in to hand it to me. The Bitch nurse then said, “Oh, its been relegated to the floor already.” Bitch please, I should have been home already where most patients are no longer using it. I had been using it. Regularly. And walking way more than the ordered 4 times a day. It was on the floor next to the chair because that is where I had been sitting until the GERD started…two mother fucking hours ago. By this point I was beyond nausea and my mouth was watering. I was almost two hours past due for my scheduled Compazine and she wanted me to prove myself. I sucked on that IS 3 times and proceeded to grab my bucket and throw up. The hard, judging look disappeared from her face and she said, “I didn’t know it would make you sick” Fuck you. Just fuck you, and go get my medications. She managed to come back with some but not all and it took her another hour to return with the Protonix and Toradol. TK and I could not believe how horrible she was, thankfully she was the first terrible nurse I had.  She definitely did not do  hourly or even every two hour rounding which was fine, the less I saw of her the better.

At 2:30 I woke up with a full feeling under my left breast. It wasn’t painful, just uncomfortable. I thought it might be gas so I woke TK up to walk the halls which made me feel like I had to either pass gas or poo. Nothing happened so I tried a few sips of hot tea. I tried to no avail to poo. Walked more. Became nauseous so I called for my scheduled anti-emetic but it was too late once again. I threw up the most rancid tasting brown liquid ever. But I didn’t care because it wasn’t bloody. At all. I was excited, this had to be a good sign right? I figured it was the small amount of hot cocoa I had drank. The next time I woke up my mouth tasted like blood. I felt better though.

TK and I went out to the balcony. You have to love a 7th floor balcony. We’d enjoyed it a few times. I considered mooning the construction men below but figured there’d be no enjoyment for anyone involved. When we got back to my room we heard a dog bark, I made TK peek out the door looking for a service dog. I wanted it in my room. That minute. There was no one there. I started crying. My favorite nurse, Maria, came in and asked what was wrong. I said I missed my dog. She suggested I have him brought in.

The surgeon came in just as I had finished shaving on leg. I sei-wrapped in a towel and came out to talk to him. Explaining that I needed to do something that felt somewhat normal. I sensed his discomfort with my partial nudity and thought it odd. I guess I’m just so used to vagina hanging out at my job that I never realized other parts of the hospital wouldn’t be as comfortable with it. Upon hearing that I was still puking he said he’d order a contrast Cat Scan if I puked anymore. He wanted me to try full liquids to see if that would stay down. I had an orange, no red dyed anything for this girl, popsicle first. I was not interested in anything thicker exiting via my mouth. When that stayed down I had one bite of Cream Of Wheat. No. Just no. It felt like I had swallowed a brick. The nausea remained tolerable but I felt like someone had punched my right side for hours. I sipped a quarter cup of water over a few hours that afternoon. Everything remained status quo. I walked to the cafeteria with TK when the nausea increased. I thought I was going to toss my cookies in front of the lunch crowd. I just kept swallowing and it stayed down. Until it didn’t an hour later. Once again it wasn’t bloody. Yay!

This young man from transport came to pick me up  for my CT scan. I got into the new fangled wheelchair

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He covered me with a white bath blanket, tucked around me. I asked for a Hannibal Lector style face mask to complete my look. He laughed way too hard. I think he was high. I wouldn’t be surprised, it’s Colorado after all. In the CT room the tech explained the procedure and assured me that when it felt like I peed my pants I wouldn’t have. I kind of wished for a full bladder just so I could prove her wrong. I was definitely feeling better than I had all week. But I’d also stopped drinking 4 hours earlier. As I glided into the machine I felt like I was Buck Rogers for 0.2 seconds. Then I realized being on my back just made the left sided pain worse so I checked out mentally until it was over. As soon as I sat up the nausea returned. I just wanted it to Fuck Off for good.

The results showed a partial obstruction. Optimistically I thought, “At least it’s only partial. That means something can get through” He ordered a Barium small bowel follow through study for Monday. I sent TK to pick up The Pooch and spend a night at the apartment. She had done so much for me. From helping me shower, including the first shower on Thursday when I couldn’t twist and reach everything. It wasn’t until the following week when I sheepishly asked, “Did I put a towel between my legs, bend over and tell you to pull it out the other side to dry me?” Yep, I sure did.  She stood as my support pole as I wiped myself. She put TED Hose on me, and any nurse knows what a task that is. She woke up almost every time I did and walked with me in the halls. She deserved a good nights’ sleep. Also, I needed my underwear washed.

I thought I’d be ok. Then the terrible CNA came in my room. I had tried to put my hose on by myself but I failed. I asked for her help. At first she turned knee-high into thigh high which were just going to roll down. Her solution was to squinch them down leaving wrinkles behind my knees, calves and ankles. I was sick of having to ask her for things twice and I figured she’d somehow find a way to fuck it up more if I asked her to fix them so I left them. When my nurse finally graced my room 3 hours into her shift I asked her to pull the foot down and twist them around so the heel wasn’t on the top of my leg. First she commented on how dirty they were. It struck me wrong. Well that and the fact it was three hours into her shift before I saw her struck me wrong. I irritably replied, “That’s what happens when you wear something for six days. I didn’t think to bring my Tide.” She then proceeded to pull them up. I lost it. Even more caustically I told her that they were knee highs, not thigh highs and that if the heel was in the right place and not halfway up my shin they’d be on right. She pulled them mostly down and started putting my socks on leaving wrinkles all the way up my leg. I kicked my sock off, grabbed the hose and de-wrinkled them, while stating the last thing I needed was a clot because my circulation was cut off by strangulating hose. Fuck me! She backed out of my room, stopped between the curtain and door and told me at least eight times that she’d check on me later. She only came in at 4am to do my assessment. I realized that being a bitch was not going to get me good care so I apologized. Then I asked how long she’d been a nurse. 20+ years on the same floor. I didn’t ask her how on Earth she didn’t know how to apply TED hose correctly when my daughter saw it done once and was already an expert hose applier.

I told  TK not to come back until after the barium study. I saw my other favorite nurse, Lisa, and her student during the night while I was out walking. Lisa was only assigned to me one night but she asked how I was doing every time I saw her. Reassured me. Educated me about the tests I’d be having. Made me laugh. Gave me hugs. She’d been off a few days and was surprised to see me. I caught her up to date. She told me what to expect with the barium study and that it could take hours depending on how bad the obstruction was. No need for TK to sit around waiting. Transport brought a gurney which made me chuckle. I no longer felt like death warmed over. Not putting anything more than a few ice slivers on top of an obstructed bowel really does wonders for nausea and pain. But apparently I needed a gurney. I got parked across the staff desk in the holding bay. I watched and listened to 5 transport people and the transport coordinator goof around. When the person  next to me, or maybe a few cubicles down snored like a bear than passed gas like a bullhorn we all snickered. I got picked up by a X-ray tech that had the coolest platinum blonde, one side shaved, pink tipped hair ever. She explained what would happen during the test and then gushed when she saw who the radiologist was going to be, “Oh he’s the best!!!” She passed me off to Tina who went into more detail and told me the barium tasted like “Tide smells” and that it would leave an oily feeling on my tongue. She also gushed about Dr. C. Dr. C walked in and I saw what all the fuss was about. I was hoping that if I told him I was a nurse he’d go a little Grey’s Anatomy on me. They sandwiched me between the standing table and X-ray machine. He angled my hips like he wanted and then thrust his big asked me to drink his the barium. It was every bit as nasty as promised but I gulp, gulp, gulped through the straw as instructed. Then I stopped, closed my eye, turned my head and prayed for it to stay down. He rubbed my shoulder and asked if I was ok. I shook my head and asked if they’d like anything washed because I was sure if I had 6x the cleaning power over other leading detergents. Whatever they were doing, taking successive images?, sounded like the inside of a casino. I told them it sounded like they were winning. Yep, I was full of more than just shit. I got laid back and Dr. C asked if I could drink a little more and then push my hip forward. I told him I could do whatever he needed me to do without meaning to sound dirty so I proceeded to turn every shade of red visible to the human eye. I’m fine when I mean to be sassy but when it’s by accident I get all kinds of flustered. He took a few more images and I got sat back up. He reviewed the images and told me I didn’t have to drink any more because he could already see the problem. While he talked to my surgeon Tina showed me how the barium entered my pouch without a problem, siphoned out the newly connected small intestine like it was supposed to and then plummeted to a dead stop where it started to trickle. It was actually pretty awesome to watch. Dr. C wanted one more image 20 minutes later so Tina sat and talked to me while we waited. Her mom had the old stomach stapling in the late 80’s and had all kinds of problems because she was non-compliant. Tina felt it saved her life though. She told me how she reacted when people asked if her mom was sick after the rapid weight loss or when people would stare at her and make comments about the extra skin. She came to her mom’s defense, she reminded me of how protective TK is with me. I adored her the moment she walked in the room, all the way through my procedure. The last image showed that another small amount of the barium had gotten through at a trickle. I was taken to the holding bay where I talked myself into keeping the Barium down, I’d been informed that sometimes it pushes whatever is blocking things through and I’d be good as new. It was difficult when the next person they wheeled past me had the worst stank ever, I’ve never smelled a GI bleed but I’m pretty sure that’s what all the hoopla is about. Ew!

TK arrived with The Pooch shortly after I got back to my room.  He laid at my feet on top of a pillow. Maria came in to see him and they loved on each other. He snuck his nose into my glass of ice chips. We took him out to potty and I felt kind of like a weirdo for needing my dog to visit for 47 seconds before I decided I didn’t care what anybody thought. He visited for a little longer  before TK took him back to my friend’s house.

The surgeon came and talked to me about what they found on X-ray. He wasn’t sure if there  was impingement or twisting of the bowel by scar tissue or a blood vessel or if when I was vomiting one of the anchoring “stitches” came loose and wrapped around some bowel between my pouch and where the small bowel connected. The obstruction was significant enough that he needed to go in and fix it. I don’t know why I’m always late to the game I really thought seeing some barium going through meant that with time I’d be fine. He told me this has only happened one other time in the 21 years and over 4,000 surgeries he’s done. He left, I cried.

The barium that got through started working and I got diarrhea. The kind that gave no warning. I had to get my sheets changed. Then I asked for a pad to sit on. I gave up on underwear. I shit on my gown and once more I lost it. This time I sobbed and called myself stupid and selfish for having the surgery. TK gave me the harshest look and told me in a very firm voice, “STOP, don’t ever let me hear you talk like that again” and left me to clean myself up. I walked into the room to Maria changing my bed pad once again. It was the third time I’d cried during my stay and the first time that she had seen me, she asked me what was wrong and I whined about shitting myself. She looked like she was going to cry with me. We ended up laughing about it instead. It wasn’t a lot just on all of the things.

I was put on the surgical schedule as a to follow case, so we had no idea what time I’d be going under.  Even though I’ve been sterilized and I certainly didn’t have relations between the two surgeries I still had to give a urine sample for a pregnancy test. I told Maria if it was positive she better just knock me out. While I was taking my pre-op shower she came and told TK she wasn’t going to be a new sister in 9 months. Phew!

I got the TED hose nurse back that night and told her I was refusing my midnight assessment so I could sleep. She did not have a problem with not having to see me and the feeling was mutual. At 4am I woke up to take my second pre-op shower but when she told me I was scheduled for 11:30am I asked to wait until change of shift. She got flustered but I assured her I would do it right at 7am.

I stayed awake so had showered anyway. I was sitting on the bed talking to TK around 6:15 when the Code Red (fire) alarm sounded. The next thing I know my room door opens and Amy, the best CNA in the whole world, barges through with a long stride and a determined look on her face. She reached the other side of the room in two strides, examined it quickly then swung the bathroom door open. By this time two more staff members had meekly stepped into my room and stood by the door. I heard someone in the hallway say, “There’s a patient in there.”  Amy gazelled it across my room and exited.  TK and I glanced at each other with eyebrows raised and WTF? looks on our faces. A moment later she came in laughing, and oh did she have a unique and contagious laugh. She explained that it was a mock Code Red and the powers that be had accidentally used my room as the location. I told her if there was ever a fire in my room I wanted her on duty, I was just waiting for her to wrap me in my sheet, pull me off my bed and down the hallway to safety. A few hours later, as we walked past her I whispered “FIRE” loud enough for her to hear.  This really is another example of my This Would Only Happen To You-itis. I loved it!

I was so happy to see Maria on my one week hospital anniversary. She came in my room right after getting report, with wide eyes she said, “I was getting coffee when they called Code Red to your room. I thought Oh no what happened to Me-tchelle” I told her, I’m hot but not hot enough to start fires.

The hospital I was at, and most hospitals for that matter, have patient information boards where they update your diet and activity and write your team’s names. Some places I’ve worked also had an area for daily or shift goals. This hospital didn’t have a goals area but seeing I wasn’t eating I took over the goals area and wrote things like “Shit or get off the pot” and on the day of my second surgery…

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I also revised the pain scale…

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They came to get TK and I for pre-op. I told anyone that would listen that the Barium was wreaking havoc and I was sorry for any streaks I left behind. I had been wearing a hospital supplied pad to protect everything, right before surgery I went to the bathroom and of course the pad fell into the toilet. I dragged the garbage can to the toilet and dug it out.  I walked out and announced what happened, honestly I can’t keep much to myself. The same anesthesiologist from the previous week came in to say hi, I once again requested Versed. My surgeon came in and I started crying. He had told me that worst case scenario some of my bowel had died and he’d have to remove it and reattach it. I was certain that was going to be the case. I was worried that my already shortened bowel was going to be compromised or I’d wake up with a colostomy. Sweet, sweet Versed take me away.

This time I woke up in recovery and was talking to the nurse. I don’t remember everything I said but knowing myself I’m sure I apologized to him for any possible poo. Not that he was going to be looking. Another nurse walked by and asked him if he was ready for lunch, he said yes and within 10 seconds two people came out of nowhere, took the monitors off and whisked me away. I was impressed and said something like, “Wow, well oiled machine. Were you two lurking in the background just waiting to get rid of me?” That’s it, that’s all I remember until getting to the room. Shoot, I don’t even remember if I was in a bed or on a gurney. Anyway, I felt great! No nausea, no pain. Turns out I had formed adhesions that pinched the bowel. He only had to release the adhesions and he did something so when it scarred it wouldn’t be able to get close enough to the bowel to happen again.

I wanted to go to the bathroom right away so I practically jumped out of bed. TK and Maria were as excited as I was about feeling so good. I peed and Wham!, nausea. Bad, bad nausea. I was freaked out that it was all starting again when probably I had just done too much too soon. I got Zofran and my IV infiltrated. My arms were both bruised and swollen, Maria looked for a new site but didn’t see anything she was willing to try. She called the infusion nurse who wasn’t able to come for a “few hours”. I surprised myself by speaking up and saying I didn’t think it was a good idea not to have IV access seeing I’d had surgery less than 3 hours earlier. I didn’t need to code without IV access. A former ER nurse came in and was able to get one in lateral to my antecubital. I was relieved. I was feeling better and in the next 4 hours I drank one whole cup of clear liquids. That was nearly as much as I’d drank in the entire previous week. I was hesitantly optimistic. TK and I walked and walked.

Lisa and her student (I wish I could remember her name) had come into my room to say goodbye. They weren’t going to be back for a few days and wanted to tell me they had enjoyed not only their one shift with me but my entire stay. Lisa said so many nice things about how she loved my positive attitude and she felt I’d do really well with all the new rules in my life. I was already teary when she handed me an ornament that says “Radiate Beauty” and said I already did, it was a reminder for the tough times. They touched my heart. I told her student to absorb everything she could because Lisa was a great nurse. Smart, compassionate, reassuring. Amazing! Maria had come in also, they all hugged me. Bitch Nurse had followed Maria in for bedside report and she sat in the back with a look on her face that said, “Why the hell would you ever do that for a patient? Ew.” I found out that she had been a fitness trainer before becoming a nurse less than a year earlier. I saw where her judgement came from. I didn’t care, I had two of the best nurses take care of me along with several other good nurses. One bad apple was not going to ruin my experience or sway my judgement that the hospital I chose was a Center of Excellence for a reason.

I did well all night. I showered right away and packed and waited for what seemed like forever for an official discharge order. We left the hospital by early afternoon.  It felt fucking AWESOME!

I have to thank TK. She did everything I asked of her and more. She saw all of me in a way she’ll not soon forget. She never complained and was supportive to my emotional and physical needs. The only way we will ever be even is if she allows me in the delivery room and has something shooting out of every orifice at the same time. Thanks kid, I love you!

On a side note, I had started a list of all of my caregivers with little notes to remind me who they were so I could write a heartfelt thank you note. I looked through my notebook the day before discharge and it was gone. Poof! I looked though it two or three times, page by page. I figured maybe someone saw it and took it thinking I was going to complain, even though I didn’t put anything negative on it. It bothered me. I looked through all of my belongings as I unpacked. I didn’t find it. Two weeks went by and I started wondering if maybe I hallucinated making the list so I asked TK when we talked on the phone. “Mom, it’s on your phone. I’ve told you that.” Seriously, anesthesia fucks you up. I will never have a surgery without someone there to keep me in line afterwards.

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Revealing Myself: The Blab

As with all of my posts this will be written from my perspective. People may recognize themselves and have an entirely different perspective. My response to them; Get your own blog.

I’m posting this part of my life in a new blog in hopes of avoiding unneeded conflict with my mom. She may come across it someday and if so I would like to direct her to the first paragraph and to my disclaimer. Most of this is not about her at all, none of it is about only her but as I say…different eyes, different perspective.

I’m not very good at keeping secrets about myself. I’m great at keeping your secrets. When anyone starts a conversation with something like, “Don’t tell anyone but…” the next words go in one ear and out the other. I’ll be present for the conversation but as soon as I walk away you’ll have to jog my memory if you want to discuss it again. But when it comes to my own stories I’m an open book. You ask, I’ll tell. Hell, who am I kidding, you don’t even need to ask usually. I don’t know where the overwhelming desire to tell my story comes from. Maybe I’m an introverted  attention whore?

This will probably be a long post and I don’t even know what I’ll end up writing or where this will take me but here goes..

There’s one thing about me that is obvious to anyone with sight. I’m fat. Super morbidly obese to be exact. That is all that some people see, even myself occasionally. My weight has been an issue for as long as I can remember. As a child and a young adult it seemed to be the focus for people that were influential in the development of my self-identity. As a child and teenager things that would take thousands of words to explain were said and done that led me to believe I was fatter than I really was.  Statements and actions that made me feel like I was less lovable/likable because of a few extra pounds.  As an educated adult I get that some of those things were done out of love, in an effort to protect me from the kinds of people that would not like me because of my size. Some of it was just kids being cruel and stupid. I have “before”  and “progress” pictures dating back to early middle school.  Who encourages that kind of obsession? In late middle school through Junior year, I worked out at least two hours a day and limited myself to 1000 calories a day. I based my worth by the numbers on the scale. I have not judged myself any harder than when I was 120 pound 14 year old and looked in the mirror and saw a fat, imperfect me.

As a child and teenager I witnessed the extremes of fad dieting and binging. What I ate was scrutinized.  It was made obvious when I made what was thought to be a bad choice, being asked “Do you really need to eat that?” or having my thigh “fat” secretly jiggled under the table. I became obsessed with food. Publicly eating what I thought “I should”, privately sneaking those “forbidden fruits” Eating in private became my way to snub my nose at those that tried to control my weight.  That obsession grew into an ongoing battle of who was going to control what I ate and a test of who was going to love me regardless of my weight. I didn’t want to be controlled. Some people couldn’t love a fat me and left. The longtime feeling of never being good enough to be loved grew and I ate more. I went from thinking I was fat to being fat. From normal weight to overweight to obese.

Then I was diagnosed with Rheumatoid Arthritis at age 27 and soared right through morbid obesity into super morbid obesity and there I stayed. I allowed myself to have unhealthy relationships and didn’t pursue what I felt I deserved out of fear of rejection.

Throughout all of those years I tried losing weight. I tried numerous ways from Jenny Craig to Phen-Fen and lots of things in between including therapy where I tried to get to the core of why I continued to abuse myself with food.  Through all of those attempts and years I learned that the most successful way for me to lose weight was working out and eating all things in moderation. The trouble was in maintaining that over the long term. I was a slave to the numbers, if the scale didn’t move I became disappointed and eventually I gave up. Every time that I gave up I climbed to a new high weight.

In 2010, I started to realize I was never going to be able to explain everything that happened to me or why it still affected me the way it did. I didn’t want to let it affect me any longer. Rather than try to discover how being fat benefitted me I decided to just face it head on. I was my highest weight, 316 pounds. I joined Weight Watchers and became more active. I became determined to change my relationship with food and my path in life. 2010 became my roughest, most heartbreaking year for me to date. And for the first time I chose not give up my pursuit of becoming healthy…mind, body and soul. Some of the circumstances I faced actually made me realize that there is far more to life than weight and that scale numbers should not something that holds me or anyone else back from realizing their full potential. For the first time in years I allowed myself to dance in public without abandon, humidity and sweat be damned. I started walking on local trails and paying attention to the beautiful outdoors. I’ll never be able to explain how I was experiencing sadness to my core at the same time that I was discovering enthusiasm for life. Those two states of mind clamored for favor for years. Recently I realized that neither one had won out and that apathy had. I don’t know when it happened but it did. It’s a shitty frame of mind to have. Especially after the experiences, therapy and self-work I’d done from 2008-2012.

I thought traveling would give the nudge and the freedom to focus on myself and losing weight. It didn’t. I have discovered that others see me as strong, lovable and worthy. I struggle to see this in myself. I haven’t learned to love myself the way I would have defined it years ago but I care about myself enough to treat myself right. I’ve nurtured relationships that nurture me and I’ve ended relationships that were unhealthy. I’ve pushed my body to do things I thought were physically impossible. I’ve shared aspects of my life that are extremely difficult. I’ve made great strides in what and how much I put into my body. But I still leaned to food for comfort. To relieve pain, boredom and unhappiness.

Last summer I realized that without help I was unlikely to lose a significant amount of weight and maintain that loss. After 25 years of different methods not working I decided to take a serious look at weight loss surgery. Of course I’d thought about it before. Every medical professional I sought care from asked if I had considered it. The few patients that had had it suffered what I perceived were negative consequences. That, paired with my own misconceptions of post-surgical life and the expense had turned me away from it. I discovered that my health insurance covered weight loss surgery which made it a more viable option. I researched it. I watched and asked questions as two friends went through it and by September decided that I was going to pursue this path. The insurance required a BMI of at least 40, unfortunately (fortunately?) that was not a problem for me. I also had to have at least 90 days of medically managed weight loss documented, an evaluation by a bariatric surgeon recommending surgical treatment, a separate medical evaluation from a physician other than the requesting surgeon that includes a recommendation for bariatric surgery, unequivocal clearance for bariatric surgery by a mental health provider and a nutritional evaluation by a physician or registered dietician. In addition to that my surgeon required 3 years worth of medical records indicating my history of obesity and all of my co-morbidities and a 5 hour course with a dietician that disclosed what to expect post-op.

I saw my surgeon in October and also started the supervised program with my PCP. As with most patients seeking surgery I became worried that insurance wouldn’t approve me, that they’d tell me I was capable of losing it all without surgical intervention. I decided to double cover myself and started seeing a registered dietician also. I made changes, I quit the 3-5 times a week Starbucks habit. I told my co-workers and friends here because they would know I was taking time off work and because I saw that they were supportive to my friends that had had surgery. I was leery of sharing my news with anyone else. I didn’t want to hear that I was making a bad decision or horror stories of somebody who knew somebody who…I had enough of my own doubts and wondering why I wasn’t capable of losing weight on my own. I also had already read and heard plenty of negative stories. Ultimately I decided it was what was right for me and that I wanted the best chance possible to lose weight and keep it off and that chance outweighed most risks. During my 5 hour class I was reminded of the statistics regarding maintaining weight loss, according to the NIH only 3% of people who lose 100 pounds through diet and exercise maintain that loss for 5 years. Even studies that look at maintaining a 10% weight loss for individuals over 300 pounds show a 20% success rate at maintaining for more than 1 year. I’ve been there. I’ve been the other 80%. The NIH shows that 95% of surgical patients that lose 100 pounds keep it off more than 5 years if they go through a Center of Excellence.

I completed and submitted all of my requirements for insurance at the end of January. On February 19th I received a call from the insurance coordinator at my surgeon’s office that the reviewer had called requesting one more piece of documentation and once that was received I’d be approved.  I was officially approved on February 20th. I was so excited and nervous. I had let my manager know my intentions months earlier and coordinating time off work seemed like it was going to be the biggest hurdle to jump but, as is the case most often, everything worked out the way it needed to.

Next post: Hospital Shenanigans

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