Call Me Mr. Swiss (because I’m full of holes)

I had my surgery November 2. No “before” pictures, no videos to provide a male perspective on this surgery, just a great deal of wondering, “Would I recommend this process now that I’ve had surgery?deep-thought

I was continually asked, “Are you nervous?” I wasn’t until I was walking into the hospital Wednesday morning before 6AM.  I was wondering what would change when (ok, and if) I walked out in a few days. It was nothing more than the fear of the unknown. The day before had been clear liquids only, and that was a little tough. I did discover chicken broth was tasty, but also discovered that even the low-sodium version is still a lot of sodium. I thought a lot about never eating pizza or fried chicken again, but soon realized that my inability to handle the responsibility such food and my body demanded was part of the reason I was drinking clear liquids.

GRIEF FOOD
Looks like a food funeral to me…

I had a scare a week prior, when I went in for my last visit with the surgeon. It was a Friday afternoon, my sister was with me as my medical proxy (it turns out I’d divorced my other one four years prior), and I weighed in at 280.  Why is that a big deal? Because I was down to 265 and at one point went on a carbohydrates bender, which caused me to gain seven pounds in 3 weeks.  I still dispute the actual number on the surgeon’s scale, because I went home and my home scale, which I know to be a scant 4 pounds different frscaredom the scale at the clinic downstairs from the surgeon’s office, put me at 268. But my surgeon said she was flagging my chart, and if I gained even one more pound I would be over my goal weight and ineligible for surgery that day. That threw enough of a scare into me that I went totally low-cal, down to protein shakes and one meal a day, plus a minimum of 12,000 steps a day. It did the trick. I weighed in the morning of surgery at 266.

The intake nurse, Kellie, was nice. We went through what seemed like a million questions, an IV port inserted, and my temperature brought up to above 98.6 degrees. I spoke with the nurse anesthetist and a few other nurses, as well as the surgeon. I don’t really remember being wheeled into the operating room at all. I was told I’d be brought out of anesthesia in the recovery room, and when I was awake I’d be brought to my room on the surgical floor.  I don’t know about recovery, because when I woke up I was in my room on the third floor, and I was in some serious pain.  Not an uncomfortable amount of pain, but serious, PLEASE-GOD-LET-ME-DIE pain.  let-me-die

My daughter was there, her boyfriend showed up, my sister and brother-in-law were there (all of the I know because it’s what I’ve been told), I had a flower delivery I did not respond kindly to, and I was in tears, screaming for someone to help me. No one would. Apparently they had given me pain meds that were only supposed to be given every four hours, and they couldn’t give me another dose for some time. In the meantime, I felt like I had been ripped viciously apart and left to bleed. I wasn’t bleeding, but it felt like I was being ignored. While I was bleeding. swearing

I have nothing good to say about the initial wave of nurses assigned to me post-surgically. Should I not say anything? I will, because it will serve to highlight the care I received later, but the first batch was led by Nurse Ratched who would not allow the LNAs to help me do anything, groused at them and me, talked back, and couldn’t have been less helpful.  Someone eventually told her that if she wasn’t there to help me, she could leave and not come back, and she did just that. nurse-ratched

A sweet LNA named Krissy came in and started setting things right, and an RN named Laura did a fantastic job helping a very aggravated patient get squared away without losing her cool. She was calm, cool, collected and nothing but professional. The overnight nurse continued the trend and was so sweet. My daytime nurse was a guy, and I had a male LNA, Chris, as well, and it was great. I like people who speak my language, and these two did.  A bit of conversation, just being cool and getting things done, went a long, long way. I was fortunate enough to have Dustin, the RN, again on my final day. The night nurse on my last night there, Kelly, was fantastic. I was a little iffy on her at first because it seemed like she was not patient-focused, but I was wrong. She gave me her hospital direct dial so I could skip the nurse’s station, which was huge. I let slip at one point that I had never been ignored more anywhere I’d ever been. I’d call for pain meds, and despite the fact that the floor was not very busy at all, it would be a half hour before they’d call down again and ask how they could help because the call light had not been shut off. So I’d remind them, and it would be another 15 minutes to half hour. Again and again and again. Thank God I had a catheter. If I had to wait for them to come get me to take me to the bathroom, I’d have wet the bed and sat in it for an hour before anyone noticed. I was still on attended walks when I got tired of waiting, got up, unplugged everything, went to the bathroom (after the catheter had been removed), went for a walk, walked the entire floor by myself, marched right past the nurse’s station into a “Staff Only” kitchen, grabbed myself a popsicle and went back to my room, where I plugged myself back in and got back into bed. No one said a word. No one noticed. I took off the DVT leg wraps and shut the machine off because it was doing nothing but alarming out. Not a word again. That part really concerned me about my stay, but that’s different for every hospital, I’m sure. My grandmother raves about the same hospital, and what do I know from post-bariatric surgery protocol?

I’ve been home for two days. Friday night was difficult, but I slept upstairs, albeit sporadically. Yesterday I felt nauseous all day long. I was going to go to Target, Marshalls and Hobby Lobby with my daughter to get my walk in. I made it most of the way through Target before I had to go back to the car. I felt feverish, and nauseous at the combined smell of Starbucks and popcorn.  I had just had enough. I came home, took pain meds and slept most of the day.  Needless to say, I’m behind on my water intake, though I think I’m good on my protein. I’m waiting for my drain site to close so I can shower. I slept better last night. I didn’t feel like I was ripping open when I moved, I was able to move onto my right side for a few minutes to alleviate back pain, and I didn’t take any pain meds. It is still very hard to pick things up off the floor, but it’s getting easier. I’m passing more gas, which is good because my stomach is less swollen which takes pressure off the six sutures. (TMI?). I’ve felt feverish. I’ve been really cold. But would I recommend this surgery to anyone else?question-mark

Still too early to tell.

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Could it be?

Could it be that I have not posted in over a month, while both of you readers have been clamoring for more?  A thousand apologies!  To say it’s been busy would be an understatement.  Where to begin…

I had reached a plateau weight-wise.  My dietician told be to maybe add some calories, so I added more protein to the menu, and it seemed to jump start the weight loss. I’ll be honest, I’d love to be further down in numbers, but I keep self-sabotaging because I’m spending more time on the road.  I know, I know..I need to plan for that and make adjustments.  I do, and then I see those golden arches and I’m McScrewing myself.McSick

The nurse practitioner seems pleased with my progress.  She keeps asking me when my surgery is ballpark for, and I tell her September/October, because my insurance company seems to be fairly surly and unapproachable on this subject. I’ve registered in United Healthcare’s “center of excellence” program, and while Portsmouth Hospital is not one of their centers of excellence, it is in network, which is akin to not having Ebola, but a slight case of Zika instead.  In other words, to them, I suck but I don’t suck as much as the guy who is going to Bob’s Weight Loss Clinic of Duluth or something.

I have finished my behavioral health classes, which were great, and so now have the dietician and NP visits every month or so, labs, which I got done today, and a few other tests, then a short class a few weeks prior to the surgery, and I will attend the monthly pre-op support groups because I like them.  I kept saying if I lost all the weight I would;t get the surgery, but with the acid reflux, I feel like I have to.  That and separating my brain from my stomach are the two biggest draws.  Not to worry – I am not going to lose all the weight (see paragraph 2).  Think About It

I am going to buy a bicycle, a hybrid mountain bike.  Dick’s has a nice Diamondback I like for under $500.  If I can find the recommended model I read about in an online magazine, I may go to a bike shop to see of they have it or will order it.  A few more weeks and I’m on it.  Medically, my back has been giving me all kinds of trouble.  The lower back, on either side of the spine, out to the middle of either half of my back.  It’s almost debilitating.  I really need to see a chiropractor unless one of you has better advice (that is my plea to you to tell me what you think).  I got a FitBit a week or so ago, and it has already got me hooked.  We had a fire drill at work today, and my first thought was not, I wonder of this is actually a drill?”  No, it was, “Awesome!  I get to add some steps AND some stairs!!”  That is the right kind of thinking.  I unintentionally did 4 miles last weekend on my walk, and posted my best times per mile.  The times kept dropping with each successive mile.  I loved it.  I’m using the Map My Walk app, and I listen to Nikki Glazer’s Not Safe podcast, which is a riot, and lasts for just the amount of time I am supposed to be out.Dick's

That’s it of tonight, I think.  It’s late, my thoughts are scattered because I am writing a song and lyrics keep running through my head.  That’s my sign that it’s time to head upstairs, put the floor AC unit in and hit the hay.  Next time I will discuss the misnamed sleep study I took at the beginning of the month.

Questions?

The (Relational) Space Between Us

Hey, it’s not as bad as it sounds.  We had our third week of what I have begun to call “Fat Class.”  Week three is reserved for prospective bariatric patients and the support people.  It was a full room, and good for those people who brought someone.  There we were, the 5 or 6 of us who brought no one, in the back row looking at each other knowingly.  We live alone, some by choice, some not, and I am confident we’ll figure something out when the time comes.  I’m sure I could get a member of my family or a co-worker to come and sit with me to make sure I’m okay.  I’ll sleep downstairs to be close to everything relevant.  But this night, I was flying solo.  Come to think of it, if I were a pilot, flying solo would be a badge of honor; it’s something one has to graduate into.  Go me.

flying solo
from robynhobson.com

It was a good class, which surprised me, because it wasn’t as much about food as it was relationships.  One of my favorite sayings regarding the fairer sex comes, of all places, from Popeye: “It’s been proven through history that wimmenz a myskery.” Dr. W. was discussing the relational system, and how it needs 3 things from all involved to keep going

  1. Flexibility
  2. Adaptability
  3. Accommodation

    Feminist popeye
    The mystery is what the hell happened to her forearms.

If one of these things is missing, the system starts to break down.  To put these things into a diagram, draw a box, and write “ME” in it.  Then draw a large circle to the right of that box.  To the right of that, draw another box and write “YOU” inside.  That circle represents the relational space.  This is where things get worked out.  I pour in my thoughts, needs, hopes, and wants.  You pour in yours.  And from that we get our compromise.  We say, “When you ____, I feel ______, and what I really need is _____.”  Keep in mind, this means that we have to tell people what we want, and we have to be direct.  Now, write all the wants and needs in the circle.  Remember the Tinker Toy exercise, where we draw spokes off the circle and figure out how to get these things in the circle?  We are NEVER, EVER stuck in a problem!voodoo doll

Picture instead a fight. Arguments and fights happen when we don’t use the relational space, and instead go around it.  Draw an arrow from your box around the top or bottom of the circle directly to your partner’s box.  Admittedly, I have worn a path of fire in the area around the outside of the relational space.  Which is why I was alone on support night, let’s be honest.  Anyway, that path leads to the pyramid of escalation.  On the base, level 1 is discussion and compromise.  Level 2 is “Attack, defend, counterattack, retreat.”  Level 3 is the level reserved for goading and button pushing (you know who you are).  Level 4 is verbal abuse – demeaning, name calling ugliness.

Argument
Careful, lady.  I’ll bite that finger clean off.

And the tip of the pyramid is physical abuse.  If something comes at us from levels 2 or 3, we must always respond from Level 1.  We could say, for example, “Could you help me understand what some of your concerns are?”  It gets to what is happening in their head, not addressing the escalation.  Nothing good ever comes from anything above level 1!

Before the class  started, I was talking to a guy in the back with me.  He mentioned that he’s been doing the exercise, eating the way he is supposed to, and he still feels like he’s gaining weight.  I feel exactly the same way!  I met with the dietician Friday, and she thinks I’ve hit a temporarily plateau in my weight loss.  She thinks because I’ve been trying to stick to 1200 calories a day that my body thinks it’s starving and is slowing things down.  So we’re going to add a few hundred calories a day and see if that changes things up.  I also need to change what I eat every day for lunch to keep my body guessing.  Not the first time I’ve heard that.  So tomorrow I will spend time looking for other lunch alternatives.  I was only up a pound over a two week period, but I still see that as going in the wrong direction.  I mean, I wound up here by overlooking one pound at a time.  It eventually became 100.  As the saying goes, a nickel here, a dime there, and pretty soon you’re talking about real money.  At least I think that’s the saying.

Gain weight
Um…no.

I was approved for the in-lab sleep study two Wednesdays from now, so I’m (not) looking forward to that.  I mean, I sleep naked, so between having to wear something to bed and being in a strange bed on a weeknight, I may not sleep at all. Thing is, the in-home sleep study isn’t as comprehensive, and apparently many people end up needing the in-lab study anyway.  So no sleep, and I might get to come away from it with a stinking C-PAP machine.  And I get to go to work the next day.  Awesome.

No Sleep
Thursday’s warning to my coworkers

The Neurologist and the 4 Components of Functional Eating

What do the two have to do with each other?  Absolutely nothing.  It just describes my day.  Or perhaps a secret 8th Harry Potter book.  You decide.

I went over this afternoon to see the neurologist for a consult.  It was supposed to be for sleep apnea, common for us non-wee folk.   But it also became a consult for my migraines.  I bought my very first house in July of 2015.  bout 3 weeks later, I fell down the second floor stairs, and hit every damn step on the way down.  I was buck naked and holding an empty laundry basket at 6:30 in the morning.  When I hit the bottom, I thought I had broken my hip.   I decided that if I could put weight on it, it wasn’t broken.  I limped around the kitchen – not broken.  I had to go to work, so I hopped in the shower.  A burning went up my arm – it turns out I had a second degree burn on my forearm from the carpet.  I got to work and my eyes started going in different directions.  I left work after a few hours, spent the rest of the day in the Emergency department, and have had migraines since, including one Thursday that brought for the first time nausea and vertigo.  That scared me a little.  That was not my first concussion.  Far from it.  I am not a pro football player, but I was a boy, and I am now a man, and I find myself sometimes in situations that result in concussions.  Don’t ask.  And if you haven’t seen the Will Smith movie Concussion, see it.  Great movie.  Not really about football at all.

Anyway, the neurologist gave me the choice of what to treat first.  I decided to treat the sleep apnea.  My reasoning was that I have to sleep every night, and I do not have migraines every day.  Also, there is a chance that by taking care of the sleep apnea, it may take care of the migraines.  The reverse is not true, and could also result in more kids for me, the side effects of which did not seem particularly pleasant.  So the medical group will submit to the insurance company for preauthorization, and we’ll see if I can do the in-lab test because it’s more comprehensive and I want this taken care of.  I rushed back to work for three meetings, then got back in the car and went back to Portsmouth, literally across the street from the neurologist’s office, for the behavioral psychology sessions required through the bariatric program.

Tonight we discussed the 4 components of functional eating patterns:

  1. Portion regulation – have a strategy
  2. Food selection – read the labels!
  3. Interval eating – eat by the clock, anywhere from every 2 to 5 hours. Meal, snack, meal, snack, etc.
  4. Compensation – if you overdo it on food and possibly stretch your pouch, then its time to increase your exercise, reduce your calorie intake, or both.

Good stuff.  Next week we’re supposed to bring at least one of the people in our post-surgical support them with us to class.  I will be attending alone.  I have support, but they will only be here if I call them.  I kind of prefer it that way.  Perhaps I’ll feel differently when the time comes.  My family are the type that are always offering to jump in and help.  I love that about them.  There are a few others, a few people at work, and a few people outside of work, but they have their own lives.

Do any of you have any thoughts about this?  I’d love to hear them.  By the way, dear reader, if you are considering bariatric surgery, I strongly urge you to subscribe to two blogs I absolutely love: rny4me just had gastric bypass surgery and chronicles it warts and all, and banded carolina girl offers a fresh perspective and encouragement.  I’ve drawn a lot of strength from those two, and I likely have not told them in any way, shape, or form, but thank you.  You are keeping me on the path.

Is my fall a fail?

It feels like it’s been a million years. Not that I haven’t had anything to say; I just haven’t had the time to say it.  I’ve read elsewhere school has been crazy for people.  It’s been crazy for me too.  Thing is, I’m in too deep to quit now.At the bottom looking up

Along the weight loss narrative, I’ve met with the staff psychologist, who is an ex-Air Force vet and I really like him.  It was a quick one hour session to sort of point me in the right direction behaviorally.  He says that in order for weight loss surgery to be effective for the patient, they MUST make changes in their behaviors surrounding food and coping. Sounds pretty simple, right?  It isn’t.

I met with the dietician, which I may have written about.  Hydrate, add protein shakes.  400 calories for meals, 200 calories for snacks.  Something every two hours.  She’s nice but I wouldn’t want to cross her.Angry Woman

I met with the physical therapist, who only needed me for one pre-op visit.  She said because I have physical issues, all I need to do is walk, not for distance, but for time.  45 minutes, 5 times a day.  That’s been really hard.  I’ve been fighting migraines for a week now, and yesterday it finally won.  It made me sick for the first time, gave me vertigo for the first time ever, and strangely, made me eat, probably because I was so stressed about it.  I was worried it might be a vitamin deficiency.  I even stayed home from work because I was still feeling the effects of it this morning.  The good news is the I meet with the neurologist next week and can discuss it further with him then.Migraine

I’ve gone to a pre-op support group. That was interesting.  I am really not used to saying this at all, but I felt like I was being judged for being the skinniest one in the room.  It’s all relative, of course, but man did I feel out of place.  It was great though.  There were panels, questions from the audience, the psychologist was there, the dietician, and several former surgical patients to talk about their experiences.  It’s nice to know that we will get through this.

I also went to the first of 5 behavioral classes put on by the psychologist.  That too was good.  It wasn’t an hour and a half where they just read the book to you.  It was practical, it was useful, it was interactive, and I got lots of good information.I learned that y responsibility throughout this process is to keep on track regardless of what is going on around me.  I need to control my own environment.  I need to have confidence I can keep the weight off.  Dr. W talked about flight sim training for pilots, and how when they go inside, the people running the sim ill throw one thing in to knock them off kilter, then another, then another.  They make failure a virtual guarantee.  Why?  Because (and here is the take-away) smooth sailing is not your friend.  We need to learn how to course correct on our own.  Having everything go right is not the way to get that done.  We need to face the challenges in order to overcome them.  Finally, we cannot view our FALLS as FAILS.  We just need to chalk it up to experience and move on, like when Tom Brady throws a rare interception (not a word from you haters out there).  He knows he will get another chance to get back out on the field and turn the INT into a TD.  That’s all we’re looking for throughout this surgery process: a win.Brady TD

Lastly, I met with the nurse practitioner today, who is on her way to Hawaii right about now.  That was sort of ho-hum, even though I like her. I got to meet her dog too, which was great.  A 5 year old yellow lab who loves to be played with and pet.  I talked to her about the migraines.  She talked to me about staying hydrated.  It was straightforward, but she did say I am in a really good place.  I weighed in at 275, but I don;t need a lot of the attention most of the others need, medically speaking.  She said she wishes I could get the surgery now.  I told her I really needed the behavioral piece of this because there are parts I am not telling her or anyone.  Like how much I ate out last week and the week before.  How I cut out of there and went to McDonald’s after my visit.  Why?  No idea.  I wasn’t even really hungry.  I guess I just wanted the salty taste of the fries and the mixture of the hamburger and the cheese swirling around my tongue.  It makes me so scared that I am not going to be able to modify my behavior enough to have this surgery be successful.  Apparently not scared enough to stop, though.  McDs Weight

Bada-da-da-daaaaa…

Restaurant Eating is Going to be the Death of Me

I just balanced my checkbook and realized how much I ate out over the last three weeks. So rather than blog about my journey here (I really dislike the word and its overuse), I apparently went out eating.  So, sorry.  Like you were hanging on every word…

I have an appointment with the dietician tomorrow.  The conventional wisdom is that my caloric budget is going to be raised. I wonder if I’ll have the guts to tell her I’ve beat her to it and done it myself.  Friday I have an appointment with the program psychologist.  I’m looking forward to both visits.  It will be interesting to see what the next stages bring.

I got a very nice compliment from a co-worker today.  I walked in to my office, and my co-worker, who usually starts in with things to do before I even get my coat off (note to reader: NOT the way I like to start my day), says, “Hey, I don’t want you to get a big head or anything…” I was wondering where this was going.  She continued: “…but you really look like you’re losing weight. I can see it in your face, and your head is getting smaller.  You had a big ol’ fat head.”  Just take a moment and bask in the glow of that statement.

I have lost weight. My head is getting smaller.  I can feel my waistline shrinking.  My unused belt loops are seeing some action, which is fun for them.  I really need to be careful about doing so much eating out.  Not sure if I told you all, but I bought a diabetic cookbook at Barnes & Noble.  I’ve made two dishes from it and LOVE them!  Last night (and tonight) I had Chicken and Spinach Avocado Lime Salad.  Homemade dressing that is FANTASTIC…I can’t wait to have more for lunch.  Red, orange and yellow mini peppers, thinly sliced red onion, tomato…it is SO good.  Perhaps I’ll post that recipe, giving full credit to the publishers of course.

Time for bed.  I have an interview tomorrow for a promotion.  Not sure how good my prospects are, but I am cautiously hopeful.  If I don’t get it, I am not going to let disappointment drive me to the buffet table. I am gainfully employed, I have a great family, people who love me, and it’s time to make changes.  Those changes have to last for the rest of my life, regardless of what life throws at me.

Bring it on.

Dumping and Excess Skin: A byproduct of gastric bypass surgery

There aren’t any good jokes about this subject.  I was hoping there were, so I could start out with one or two. But alas, I must research this instead.  You may notice I went a little hyperlink happy today.  These are all short articles that apply to today’s topic.  They’re good, and as far as I know, virus-free.  They will all open in a new window so you won’t lose your place in this riveting blog.

Dumping – It’s Not Just For Breakfast Anymore

University of Rochester Medical Center, in an online article reviewed by Joy Fincannon, RN, MN, say healthcare providers don’t really understand why dumping happens. Dumping happens when the solid part of the food we eat gets automatically dumped undigested into the small intestine because the stomach is now too small to handle the food. It can result in a serious nutritional deficiency which can have long-term effects on your health.  Dumping syndrome affects 15 – 20% of post-surgical gastric bypass patients, and a small amount of people can’t get rid of the syndrome once they have it.  So if I’m understanding them correctly, it’s like herpes of the stomach.  Are you reading it the same  way?Hart Dumbass

Dumping syndrome is broken up into to categories: early dumping and, you guessed it, late dumping. Easy dumping happens anywhere from 10 – 30 minutes after a meal, and late dumping happens 1 – 3 hours after eating.  I’m reminded of Cosmo Kramer in the Seinfeld episode The Pilot.  Elaine asks Kramer, who is backed up and resistant to an enema, if he is going to the taping of Jerry and George’s “show about nothing” pilot.  Kramer says, “No. No.  I’m gonna stay home.I want to be close to my home base in case there’s any news from the front.”  Great episode, and you can read the script here.Kramer gif

Anyway, it’s enough to scare some people away from gastric bypass altogether. Typical symptoms of early dumping include bloating, sweating, abdominal cramps and pain, nausea, facial flushing (is that an intentional pun?), stomach growling or rumbling, an urge to lie down after the meal, heart palpitations, dizziness or fainting, and eventual diarrhea.  Eventual. Like you’d be praying for the relief that diarrhea brings. I don’t know.  It sounds like the moments after a meal at Applebee’s to me.Applebees

 

 

The treatment includes splitting your caloric intake into six smaller meals, not drinking any liquids until 30 minutes after the meal, and lying down for 30 minutes after you eat.  Like I have time for that.  “We’re cleaning up.  Where are you going?” “Um…I have to lie down for a half hour.”  Yeah. Let’s see how that plays in Peoria.  Complex carbs can help, and watching what you eat is the best way to avoid dumping.  Dr. Fred Pescatore says avoid the surgery totally, thinking it completely unnecessary and a quick fix by us fat folk. Read his thoughts on the subject for yourself and tell me what you think.  I think dumping is worth the risk.

Stomach Cramps

Causing a Flap: The Excess Skin Problem

Excess skin, on the other hand, is absolutely going to happen.  It is a natural byproduct of rapid weight loss, and the one that really gives me pause. Think Adam Sandler in the dream sequence in Click. Boston Medical Center sees it as an inevitability, and even says exercise won’t shrink it because most people of the size to be considered for gastric bypass have already stretched their skin to the point it will never tighten. Read the article here.  Here’s the other thing:  you can get plastic surgery, but insurance typically won’t cover it.  One of the speakers at my information session said she saved and took out a small loan to pay for it, and it was completely worth it for her.  She said it cost about $10,000.  Leslie Alderman writes in The New York Times (2010) that the costs can reach $20,000 or higher.  Perhaps that’s a good article for another time.Money

It should be noted that I met a gentleman a few years ago who lost somewhere along the lines of 400 pounds through diet and exercise.  He had to have two skin removal surgeries.  For the record, he looked great, so it does do the job.  Just do yourself a favor and find a highly qualified plastic surgeon.  Do your homework.  We’ve all seen the pictures and the shows on TV.

I think you’ve reached your limit for this today.  If you’re curious, I ate with some coworkers at Applebee’s today.  I was not good.  2 Chicken Won-Ton Tacos (255 Calories), Chicken Caesar Salad (side-320 Calories) and a lunch size of the 4-Cheese Mac & Cheese (640 calories).  It was cold, snowy and I wanted comfort food.  I have to stop “slipping.”  Really it’s falling.  And it’s intentional.  I don’t know why I would want to sabotage myself.  It’s stupid and dangerous.  That is the kind of mental space that leads to dumping!  And we’ve now come full circle.  Here’s a picture to show how dangerous it is to ride the fence.Fencesitters

The pizza…the chocolate

Good evening, kind reader.  I don;t have long.  I’ve wasted a good part of the night buried in spreadsheets making sure there’s enough money left at the end of the month.  OK, so maybe it’s not a waste.  Anyway, I’m tired, and my laptop battery is almost gone.

That pizza I ate the the other night still seems to be making me feel full, like I’m carrying it around still, which I decidedly am not.  Good Lord did I feel sick after eating that thing.  It wasn’t even that good, which makes me feel better, like maybe I’m losing my taste for pizza.  But the carb overload just made me feel sick, and sick I got.Full belly

Now the issue is Easter candy.  I like the quick burst of energy chocolate gives me.  My boss happens to keep a bowl of Cadbury Dark Chocolate Mini Eggs on her desk for the team.  Her boss brought in Girl Scout Cookies: Samoas and Thin Mints.  Fortunately I’ve been able to restrain myself when it comes to those, because I am a Tagalong man.  I’d be lying if I said I haven’t had a few though.  The good part is that they are at the back of the room, where I seldom go.  But it’s like they are calling out to me.  With the cookies and the candy it’s like a confectionary Scylla and Charybdis.  I won’t weigh myself until Saturday, so there’s time.  Well, a day and change.  I had a few graham cracker squares with low fat peanut butter for dinner to come in under my  calorie budget today.  I feel full still.  It has to be the pizza. Scylla and Charybdis

On a non-food related note, my debit card was compromised the other night. I’ve been surprisingly unstressed about it.  I had added an Uber app to my phone and entered in my card information, and took one ride, to a bar with a buddy of mine on a guys weekend.  And really, if I’m being honest, we had to use Uber because he’s pissed off every cab driver in the greater Portland area.  Anyway, two nights ago I get a text from an Uber driver telling e he’s here, and is the hotel the right place?  I told him he had the wrong number.  He cancelled the call.  not 5 minutes later, he texts back asking if I just ordered another ride.  I told him someone was messing with both of us.  I opened my app, checked the map and he was in Scranton/Wilkes-Barre, PA!  I fired off an angry email to Uber telling them to cancel my account, refund me the $31 and close my account.  They were gracious in defeat and did all I asked them to.  I called my bank, not wishing to see more money come out (because I just got paid, got a student loan refund, and a tuition reimbursement from work).  They shut my card down immediately, refunded me the $31 (I assume they will get their money from Uber’s refund to my account), and shipped me a new card 2 day air and waived the fee because I keep no credit cards nor do I bank elsewhere.  So I can go…nowhere this weekend, but still. It was surprising.  We just can’t assume anything is safe anymore, and it makes me a little sad.  And angry at those who would steal the money others work so hard for, like we can afford to give it away without a fight.  Grrrrrrr….

Identity-Theft

OK, I’m at 10% now and my eyes are getting heavy.  Time to put the peanut butter away, brush, floss and sleep.  Next time, let’s talk about two side effects of gastric bypass : dumping and excess skin from rapid weight loss.  Fascinating, right?Dumping

Meet The Clinic

Thanks to those of you who stopped by to say help after my first post.  I appreciate it, and appreciate the opportunity to expand my blogosphere horizons.

I promised I would talk about how I came to the weight loss clinic I did. It was funny, in this day and age, that it was a highway billboard in New Hampshire that led me to the Portsmouth Hospital Weight Loss Clinic (http://portsmouthhospital.com/service/surgical-weight-loss-services).  I drive past it occasionally heading north, and finally decided to do something more than look at the big picture (pun absolutely intended).  I went online to do some research (I had already done the research about the type of surgery that fit my goals, so this was just to see what they had to say for themselves), and while I was there I registered for a free information session.  My mind immediately took me to when I was a kid, and my father, always on the lookout for free stuff or a good deal, would drag my mother, sister and me to these seemingly all-day timeshare sales pitches where you registered and got a free gift. Except the free gift at the weight loss clinic a) isn’t free, and b) isn’t a week at a timeshare in the White Mountains in the summer. It’s not even a toaster.  It’s the opportunity to change your life using surgery as a “nudge” in the right direction.

As I sat down in the front of the conference room, I made a great show of reading through the handouts, which included the PowerPoint, the application for surgery, and other facts and requirements.  I was really thinking, “Please don’t let me be the fattest one here tonight.”  I didn’t dare turn around.  The session was informative.  One of the surgeons spoke, the nurse practitioner spoke, the staff psychologist spoke, but the best part was when two former patients came up to talk and answer questions.  One, who now works there, even brought pictures of herself at her biggest.  She weight somewhere close to 425 pounds when the pictures were taken, and here she was looking all “normal.”

When it came time to go, I got my first look at the crowd of people being me. It turns out I was the thinnest one in the whole room!  Did I feel better?  No!  I still felt like Fat Bastard from the Auston Powers movies.  I felt like they were looking at me thinking, “Hey slim, why don;t you make way for those of us that really need this.”  In my shame I left, but with a determination I’d not felt before.  I knew I had to lose 10%  of the difference between my body weight and my medically ideal weight, which was 10 or 11 pounds, to even be considered.  But I had to go get my official weigh in at the clinic itself, bring the app, and call the insurance company to determine coverage.  The hardest part was the damned instance company, but I got there.  Fortunately I have a background in Human Resources and benefits administration specifically, so I was ahead of the game.  Let me just say this: if you are considering this surgery and have to have that conversation with the insurance company, have a pen and a piece of paper handy, and know what to ask.  If you need or want to, reach out to me.  I’ll let you know.  Be familiar with how your insurance works too.  That could save you lots of money, or at least help you plan.  I really recommend the full amount of Flexible Spending allowance on an FSA card if it’s available to you at work.  No sense in being silly about it.

I ran over to the clinic on a Friday afternoon on my lunch break, which was really convenient.  THat’s the thing about my insurance, by the way, and maybe yours too.  Not a whole lot is convenient for the patient.  If I want to only pay 10% in-network co-pay, I have to have my surgery an hour away from home, and get all my pre- and pot-surgical support there as well.  That means taking at least an afternoon off from work and driving an hour one way.  I elected to stay close, have support handy when I needed it, and only need to take a lunch hour.  I mean I t’s not like I’m going to be able to really eat much more than sit for six weeks anyway. (It’s not that bad – it’s a gradual progression in the volume).  The staff was great – very friendly and accommodating.  I had a nice chat with the Nurse Practitioner while we were getting set up to get weighed. She asked me questions, and it wasn’t an interview or interrogation; it was a conversation and a dialogue,  very comfortable and comforting.

I weighed in at 291 pounds, which was “better” than I thought.  There was no shame, just a “Let’s go schedule your appointment with the nutritionist.”  Gladly.  Made it back to work with a few minutes to spare.  Right on.Dead Sexy

And Away We Go

I decided about two years ago to look into gastric bypass surgery or some sort of bariatric surgery. I knew I would need to seek some sort of psychological support, so I saw a therapist for compulsive overeating.  I was a lot thinner…once.  I lost 100 pounds…once.  Then I got hurt on the job and the weight started to go on.  That was 11 years ago.  Counseling was good.  I had some real breakthroughs and after my therapist left for warmer climes, I decided it was time to move forward.

I want to use this blog as a diary of sorts, as I go through this process.  Perhaps it will offer some comfort or assistance to others in the same boat.  Perhaps it will serve only me.  I have no idea.  What I do know is that after 10 days of eating a 1300-calorie a day diabetic diet, I was craving the hell out of a pizza tonight.  I called my mother, who happened to be at a pizza place, to talk me off the ledge.  After a half hour,  I got what I was really looking for, I think: permission to order a pizza.  I realized that the problem was that I didn’t have a firm meal plan for the evening.  I have the groceries in the house.  It was a lack of a plan. I’m reminded of the old saying “Nobody plans to fail; they only fail to plan.” Bingo.

I still ordered the pizza and I feel awful.  I’ll pay for it later with a jump in weight, or acid reflux tonight.  I’ll feel guilt and shame, and hopefully I’ll get back on track tomorrow.  Speaking of tomorrow, hopefully I’ll have a chance to talk about the folks at the weight loss center and how I got there.FullSizeRender