Goodbye 2012 Hello 2013

The New Year will be upon us all in but a few hours.  Hard to imagine that 2012 is done already!  This has not been an easy year for us.  A year ago we started Operation Stork, and honestly I was pretty convinced that it would happen within a couple of months.  But alas, it was not meant to be I guess.  This year also saw the deaths of a couple of close family members which was difficult for sure.

However, 2012 has been a wonderful year in some ways.  I will always remember this year as the one in which I was sleeved.  Even though it was only 3 weeks ago and therefore really at the end of the year, the procedure was definitely my high point for this past year.  Before this, I had been drifting aimlessly waiting for either the Stork or for surgery, and at least one of the two happened!

I can't help but wonder what might lie ahead in 2013.  The most obvious wish that I have would be that I lose a little weight and gain healthy tendencies.  I have absolutely no idea what I can expect with regards to weight loss, but at least I can expect to lose.  After the epic fail of last night, today my total intake has been liquids (mostly water and a little apple juice), 1/3 of a bowl of oatmeal, and 1 scrambled egg with a slice of low-fat cheese.  And I was stuffed after each "meal".

This coming year will certainly be one of discovery as I get to know my sleeve and what it will (or more prominently will NOT) tolerate.  I am enjoying the feeling of restriction in a way that has never been possible.  With every morsel that I ingest or even every sip that I drink I constantly have to evaluate my body's response.  This, in turn, makes me far more in tune with my body than I ever have been before.  I look back at all of the mindless eating of my past, and I'm boggled at how quick I could shovel in a major amount of food and not even have to think about how my body reacted to it.  I am thankful and ecstatic that I am not able to do that anymore.  I am also really happy that when I have a little bit to eat or drink, I quickly fill up and feel very satisfied.  Hunger has not been a part of my life now for 3 weeks, and life is completely different.

Honestly I have no idea if I'll ever get pregnant.  But, at least now I do know that I'm going to be much healthier and much happier.  I will be a better person - and hopefully a better Mom - than I would have been had my weight continued to climb. 

Specific things I'm looking forward to for 2013: re-joining a local gym (I think I'll start back with Curves because I had SUCH fun there), re-joining Zumba, re-joining Water Fitness.  Actually, I'm looking forward to re-joining living my life. 

I can't imagine how much better I will be a year from now.  Not solely because my weight will be lower, but I'll be actively pursuing life instead of watching it drift by. 

In 2013 I will continue to get to know my new sleeve.
In 2013 I will learn to eat based on nutrition.
In 2013 I will be active and will pursue physical endeavours.
In 2013 I will travel to Europe for 3 weeks.
In 2013 I will NOT have to wait for a stork, or wait to have surgery.

In 2013 I will LIVE.

Happy New Year to us all!

Under Pressure

It might be hard to believe that I'm a perfectionist, given that I let my weight get up to over 400lbs.  My house has its usual complement of dust bunnies, and the inside of my car is not show-room quality.  I might even have a few garments hanging in my closet which are beyond "well worn" with buttons missing and the like.  And trust me, the list goes on...

Perfection, as elusive - impossible - and even imaginary as it is, remains something that I seem to pressure myself about in certain aspects of my life.  Thankfully I have known this about myself for a long time.  I can actually pinpoint the exact moment when I became self-aware.  It was in the Fall of my Grade 4 year which would put me at 9 years old.  I had always done very well in school (being born a total people-pleaser made me try my hardest to do well academically to please my parents). In the early grades of Elementary school my academia consisted of things such as drawing trees, playing recorder, and learning about Roy G Biv and the colors of the rainbow.  However, in Grade 4 there was a tangible difference in the level of learning.  Tests were suddenly more challenging, and back then the results came in the form of a red number (a percentage) instead of a letter such as A+ at the top of the page.  See, with an A+, it would not be unusual for others in the class to receive the same mark.  Once the numbers - as in percentages - started to appear, I knew I was in for trouble.

My competition was a nice girl named Leslie.  All I knew about her was that she owned a horse, and could draw beautiful pictures of it.  She was friendly in a shy sort of way, and soft-spoken.  Sitting across from me, I could easily see her results on any project or test that was handed back throughout the rows in the classroom.  The two of us had pretty much been the kids in the class who did the best.  Now, however, with the introduction of these forsaken percentages, it was clear who was actually on top.  You guessed it, it was Leslie.  I'll never forget the moment when I saw the bright red 100% gleaming on the top right corner of her test.  It was if time had stood still.  The person behind me had to kick my desk to remind me to keep passing the tests back down the row.  When I looked down at my own paper, I had been given 98% (I had made an unusual spelling mistake somewhere in the page).  Immediately the floodgates opened, and I had a new source of self-torture.  On top of wondering things such as if I was actually the fattest kid in our town, if I was pretty enough, if I was gifted enough, if I was popular enough... I now had a concrete and irreparable source of comparing myself to everyone else - in the form of a bright red percentage on the top of every test.  This led to me basically giving up.  I still did ok in school, but once I received that first mark that was lower, I no longer saw myself as smart as I had before.  In turn, I sank even further into my own dark world of not good enough - all because I had a mark that would still have been an A+ if I had just looked at it in a different way (OR chosen not to compare myself to others... OR chosen not to look at a classmate's paper!).

Fast forward 30 years.  Thankfully some of the bumps along the road have been ironed out with a little maturity.  I no longer compare myself to everyone in the room.  BUT, I do have certain tendencies about perfection. 

My VSG journey has been a source of such torment.  During the 2 week liquid trial last spring, I lost 18lbs.  I was delighted about this until I heard in our support group that another person lost 20lbs.  The all-too familiar pangs of "not the best" started in my head.  I pushed them aside.  After all, this journey is about becoming a better me - not a perfect one - because let's face it, perfection is impossible.  Besides, who in their right mind would want the pressure of being perfect????  I think that this is also playing a major role in my decision not to weigh myself, but I'll write more on that next time.

Last night officially marked 4 weeks that I have been on liquids (one week pre-surgery, and 3 weeks post.)   While the liquid stage is prescribed for 4 weeks post-surgery, many of my friends in our support group have moved up to the next stage of mushy food at the same point that I am at.  I had initially planned on being the "textbook" patient, and if liquids were advised for four weeks post-surgery, then this chick would be doing them exactly by the book.  A couple of nights ago I was delighted to meet with 3 other girls from our support group - all of whom have been sleeved this Fall.  We compared notes, and they encouraged me to stop being so analytical about my progress. (I had been afraid to swallow many things even though they are approved at the liquid stage).  When I proclaimed my intention to stay on liquids for one more week - they laughed.  Turns out I had been approaching this all wrong, as one explained.  The liquid phase is meant to boost our recovery, and gradually introduce new foods to our new sleeve.  (I had been hesitant to even consider adding anything new, and had not even started to conceive of adding a little texture other than fluids).  Oops.

Armed with the knowledge that I had been putting myself under too much pressure to have a perfect journey (sensing a theme here....) I went home Friday night and tried a bowl of Cream of Wheat.  By bowl of course I mean 2 spoonfulls.  And although I detested Cream of Wheat as a child - I thoroughly enjoyed it and it went very well.  The next day I even tried a slice of cheese (by "try" I mean that I nibbled a small corner and chewed it 30 times).  It tasted like heaven and also went very well.  Armed with the knowledge that I should at least consider trying some items from the mushy stage at this point, I moved forward.

Well.  Last night I figured ok, try something else.  I had 2 very thin slices of turkey breast from a deli and a small teaspoon of potato salad which I mashed to a paste.  I took 20 minutes to chew these items thoroughly.  It went well - or so I thought.  Then the pain struck.  Pain doesn't actually even begin to describe it.  It was if there was a giant clamp on my innards, and that every scrap of the few morsels that I had ingested were suddenly at war with my digestive system.  I sat at the table for an hour, head in my hands, and was so uncomfortable that I removed every piece of jewelry that I had on.  I also got the shakes, and was freezing cold.  I went to bed at 8pm wearing thick socks with my pajama pants tucked in, my pajama shirt tucked in to my pants, a sweater, and a wool winter cap.  All of this was underneath fleece sheets, an electric blanket which was up as high as it could go, and 2 quilts. 

I'm sitting here typing this at 3am as I could not lie down any longer.  My stomache is still at war with my body, and there is an incredible amount of acid ascending my throat.  Even the prescribed meds aren't helping... but I feel like things are easing off a little.

I have broken my record of perfect patient.  I am no longer textbook.  I pushed the envelope a little, and I failed miserably.

But - I learned a very important lesson in the process.  I am not meant to be a perfect patient.  That person doesn't exist.  Also - through each stage of my progress I will need to be completely OK with trying new food and having them fail - or else I'll be relegated to a life of water and broth - and that is not perfect by any means!

Today I have decided to go forward with forgiveness and acceptance.  I choose to remove the self-imposed pressure that I have been under, and accept the fact that this journey is meant to be one of trial and sometimes failure.  I know that if I stick to some imaginary pursuit of the perfect journey I will only end up sadly disappointed. 

Maybe that makes me the perfect patient afterall...

The Unfit Physician

Thankfully the journey to my sleeve was followed very rigidly by a Bariatric Team.  After the referral there was Orientation, clinical visits, extensive medical testing, fluid trials, and specialist appointments.  I spent much of 2012 feeling like a lab rat and I honestly couldn't have been happier about it.  I am VERY thankful that here in my province the procedure is new enough to warrant rigorous examination.  I have follow up appointments with the Team and Surgeon for the next 5 years.  I also opted to join a formal study of the VSG (Vertical Sleeve Gastrectomy) patients in hopes that the program might be extended to even more people. I was one of the lucky ones.  I was referred just one year ago, and surgery was completed 12 months later.  Right now the current wait time is 4-5 years. 

If you've been reading this blog, you'll know that Hubby and I also spent this year trying to conceive.  The plan had been that I would take whatever came first.  Well, the call for surgery came in October so that ended all plans for Operation Stork.  According to my surgeon and team, if things progress well for me in 2013 nutritionally, I will be given the green light to start trying again in one year.

Along the way we had a few bumps.  Most notably this past August.  Before I got the call with the surgery date, Hubby and I were referred to a local specialist with regards to pregnancy.  Thankfully I had "googled" this Doctor and knew from comments on "Rate my MD" what to expect.

(Note: I understand that the issue of a morbidly obese female wishing to procreate is complex.  And yet, it does not always have to be.  The overall picture of your health cannot solely be based by the numbers on the scale.  Yes, being morbidly obese makes me at risk for certain diseases.  So does smoking, drinking, sun tanning...  Remember, my blood pressure has always been normal.  My bloodwork has always been perfect.  My blood sugar has always been normal.  Even my cholesterol was great!  One specialist whom I saw early in 2012 -who was sadly not taking new patients -  told me that she would rather have me as a patient at my weight than a person of a normal BMI who smoked.  The doomsday scenario of a large lady bearing children as a disaster is simply old school and not accurate...  and tales of pre-eclampsia, gestational diabetes, and septicemia are certainly valid yet are often exaggerated.  Again - overall health has to include the numbers on the scale but cannot be limited or defined by them.)

Soooo....  Hubby and I went to said appointment.  At this stage, it would not be unusual to perhaps try medical assistance such as clomid to boost ovulation.

Of course before we could see the Dr, a kind nurse took my height and weight.  I briefly thought about skipping that step so that the Dr. would actually see ME and not the number.  But, being ever the good girl I did as I was asked.  Stepped on the scale, and while I prayed yet again that I hadn't gained, I also found myself praying that I had grown 5 inches or more to lessen the BMI.  Don't worry, I know that is not possible!

We were brought to an exam room, although looking back there was certainly no need.  The Dr. could have done the rest of this in the lobby (which, by the way, was plastered in wall to wall images of babies..... not exactly a good thing if you are there to find out that you are infertile...).

The Dr. breezed into the room, chart in hand.  She was beautiful, with blonde hair and limbs that seemed to go on without end.  She was thin and was as graceful as a ballerina.  I'm not sure if she has ever been at war with her body or the scales, but she did not appear to be battling either that morning.

Without looking at me - she artfully dodged this by looking at the wall, the lamp, Hubby, the floor - she addressed me by name (although sadly it was not my name!) and although I gently corrected her, in the next 3 minutes she used 4 variations of names that were not mine.  Not once did she look me in the eye.

Her message - which was succinctly delivered in 2 minutes flat - was that at my "current STATE" it would not be ethical for her to assist us on our journey to conceive.
-----
(Pause while I fill you in...)
First of all, a Dr. should be able to look at a patient, no matter how horrific they may appear.  I assure you that other than being large, I am quite pleasant looking.  I do not have horns, warts, or other physical deformities.  I did not have anything in my teeth, nor boogers hanging from my nose...
Second, with all of the education these people get, a Dr. should be able to call you by the correct name.  It is not a reach to assume she could read.   And I know from seeing the chart that my name was clearly printed - right next to my height and weight.  I don't know if she was stuck on the numbers in the weight box or what, but there is simply no excuse for calling me 5 different names especially when I had corrected her the first time...
Last but not least.... morbid obesity is a medical term.  Some consider it a disease, and some a disability.  To refer to my weight as a "STATE" was the worse than looking at the floor and calling me the wrong name... it was just plain uneducated.
-----
So... without any interaction from us, she stood up and as she exited through the door she turned and offered the only suggestion she had - "if you have 15 thousand dollars perhaps I could refer you to a clinic in Halifax where you could go to store your eggs IF you have any left."  Exit Doctor, stage right.

Ironically, I left that appointment with my head held even higher.  I didn't get assistance, information, or even guidance.  But I got clarity:  this lady was not meant to be our Specialist.  End of story.  A year from now, hopefully we will be given the green light to try again.  Should we need another appointment it will simply be with someone else.

I called this post The Unfit Physician.  Even though she was quite fit physically, she was not "fit" to communicate with patients - or at least those of us of size.  People in the medical profession need to be able to communicate with patients, or at least address them with some modicum of professionalism.  I didn't expect her to understand anything about me or my struggles with weight... come to think of it I didn't even speak other than to correct her on my name.  She seemingly thought that she knew everything she needed to know about me based on the numbers on the scales - which is a very sad conclusion for a Dr. to make. 

After all, "do no harm" means more than making a mistake during a procedure...

Major News... m-a-j-o-r!

Ok, so first off I most wholeheartedly apologize to the handful of you who have been waiting for an update.  Life got in the way of writing about life. And I most certainly have missed writing.  So, with my spirit renewed and with steadfast conviction - I pledge to write far more regularly now that I have hauled my head out of my ass! 

The news:  I have had surgery.  Santa came early and brought me the best present.  I am the proud owner of a sleeve where once my stomache was.  For any of you who are still following from my WW days, I commend you for fighting the battle and being able to do so without having to have surgery.  Battling weight is not easy.  I wish I could have joined the battle way before I got to 414lbs because I possibly would have been able to avoid this drastic measure.

That being said, my surgery went very well.  I had no complications.  I'm 2 weeks post op now.  After a 3 day stay in the hospital I was released and sent on my way.  I no longer have any sort of hunger.  This is likely due to two things:  first of all, my body has better sense than to want food because I simply can't tolerate it right now.  Second of all, the part of the stomache that produces ghrelin (which is the chemical signal for hunger), has been removed.  Either way, it is refreshing to live without hunger and it is completely new territory to live without the desire to eat.

My biggest challenges right now are staying hyrdrated to avoid re-hospitalisation.  I can currently consume 4-8 ounces per hour depending on how my sleeve is feeling.  Every small (and incredibly s...l....o......w.....) sip that I take is a journey.  I have to evaluate how it feels going down, and if it is met with any disagreement from my sleeve then I have to stop.  I am finding this difficult.  I hit a low on Christmas Eve, when I found that I could simply not tolerate any liquids at all.  I was so dry that I didn't have enough saliva to dissolve a TUMS (and trust me, after this surgery, antacid tablets have been my happy pills).  My eyes felt like there was sand in them.  Thankfully my loving Hubby encouraged me to try to keep at the liquids, and Christmas Day I was feeling much better.

So.  What is life like now?  Life is simple yet complex.  My hunger is gone, and eating is out of the question, which makes this simple. The complexity comes in figuring out what I can tolerate. For the first 4 weeks post-op, I'm on a full-fluids which means that anything I ingest has to pour like milk (or dissolve in my mouth).  The next 4 weeks after that I'll be on the "mushy" stage, where I can enjoy servings of epicurean delight such as 1 scrambled egg or 2 tablespoons of mashed turnip.  In the long run, living with a sleeve means a drastic reduction in the amount I can ingest, but eventually I will be able to eat a variety of food just in smaller amounts.  My sleeve will not stretch very much - so if the most I can handle is 8 ounces for example, my plate will look very different from before.  1 ounce of steak for example is the size of a matchbox.  I've been on liquids now for 3 weeks including the 1 week pre-op.

Is it hard?  YES (and no).  It is hard to keep hydrated.  Sometimes my sleeve simply does not want anything going towards it.  It's kind of like trying to feed an infant.  I never know how something will do when I send it down.  My food (ie broth) constantly gets cold on me because it takes so long to consume it in tiny, thoughtful sips.  I really miss being able to take a big gulp of drink.  But trust me, when you've felt the wrath of swallowing too much (which feels like you have swallowed a soccer ball that is on fire), you learn really quick to take it slow.  The part that makes this less hard is knowing that I simply can't do anything else.  There is no cheating at this - it is physically impossible at least at this stage.

Christmas dinner for me was 2 tablespoons of turkey broth.  I tried a little cranberry sauce but couldn't tolerate it.  I did have a little trifle which my Mom made special with no-sugar added jello (which is strangely ok at this stage as it dissolves in the mouth) and low-fat cream.  In the amount of time it took me to sip my broth and trifle, my in-laws had consumed not one but 2 gargantuan servings of turkey dinner.  My Hubby's plate was piled so high it looked like a mountain range in Nepal.  My family felt bad - they felt sorry for me .  In turn, I felt like screaming at them.  I mean, how can you feel sorry for me???  I've just done something incredibly brave to drastically change my life - and yet you didn't feel sorry when I sat in front of you at 400+ lbs and ate til I hurt??????

Speaking of weight, I am sick of it.  Some people who get sleeved are fascinated with the weight loss which usually seems to be pretty drastic in the first little while.  I am not.  I know myself too well.  I failed at WW because of the negative relationship I had with the scales.  I put WAY too much pressure on myself, and the journey became all about the numbers. 

I want this journey to be about improvements.  About feeling better.  About the little things that I notice (or the bigger things).  I did take my measurements (with the help of my Mom) the night before surgery.  And yes, I took my "before" pictures wearing tighter clothes.  That way I'll have something to compare myself to other than the scales.

The numbers on the scale are just numbers.  They can't tell what kind of a person you are or measure your kindness.  They don't reflect that you have survived all sorts of horrors and come through the other side.  And they can't gauge the changes that are happening within.  And until I can see the results on the scales as just numbers and NOT use the results to wage war on myself, I won't take part in knowing them or promoting them.  I know it is sort of a backward way of approaching things, but for now at least that is what I feel I need to do.  I feel better than I did 3 weeks ago.  In fact, while in hospital the day after surgery, I was moving better than I had the week before surgery. 

I have my first clinical visit next month, and maybe I'll change the way I feel about the scales by then.  But for now I think I've completely realized the extent that I allowed my own perception of the scales bother me before, and I won't allow that to happen again.

Anyhow - that is all the news that is fit to post.  And I promise to keep you posted.  Blogging is a wonderful way for me to keep track of me and how I'm feeling on this journey, so I'm doing this selfishly for me but maybe if I can help someone else even just one more person, I can reap even more rewards!

Oh and for those of you who are celebrating the holidays, Merry Christmas to you and yours and all the best for 2013!