VSG Journey Update 3 Weeks Out from Surgery

My current status as of Wednesday, June 5th:  I am three weeks and a day out from surgery!

From discharge day (Thurs., May 16) I did one week clear liquids and two weeks full liquids. Clear liquids were pretty dang hard and I felt weak much of the time. I also failed miserably at getting all my water and all my protein in each day. Full liquids made me immediately feel better although I must admit that I grew SICK of protein shakes and also failed at getting my protein or all my water in each day. I did a lot better, but still had trouble. One evening after Jefferson Chorale, we all went to TGI Friday's afterwards. I sampled their dark French onion soup (without the toppings or eating any onions.....plus I hate onions) and their broccoli cheese soup. I had never in my life had broccoli cheese soup. The Fr. onion was ok and I was able to get in a couple of spoonfuls. Then....THEN....the BROCCOLI CHEESE SOUP was from HEAVEN. Yes, it truly was. It made my stomach very grumbly, but it went and stayed down just fine. I took the rest home and had it for two more days. Later, I read somewhere that fibrous veggies like broccoli are to be avoided, but I feel like it was pretty ground up and avoided all chunks anyway :-)

Now, I am MORE THAN READY to begin soft foods. Some people call this stage "the mushies", but to me that just sounds gross. I can't do pureed foods unless it's something that is actually supposed to be pureed. Last Friday, I tried a tiny bit of lean, very thinly-sliced deli turkey and it went down and stayed down just fine. I was OVERJOYED! I had it with half a Babybel soft cheese. I've been doing that once a day since Saturday. I also tried scrambled eggs with cheese. Never in my life had I ever had eggs with cheese, but it tasted good. I ate about 1/3 of one egg and it felt like a brick in my stomach for several hours. I did not feel ill, just heavy. I decided to wait a bit before having more of that.

Tomorrow, I begin soft foods and I think I'm supposed to introduce one new food a day. If anything doesn't settle well, I am to go back to protein shakes or something mild that did work well. I'll continue the deli turkey & Babybel cheese. The first new things I will try will be soft, baked fish, refried beans & grated cheddar, chili, and maybe scrambled eggs again. I'd love grits, but am not sure yet about them. I might make some more egg custard. I actually went and bought ramekins, learned how to make egg custard and made it, sugarfree. I didn't like it so much, but it was ok. I can use the little bowls though...

I really would like to try the "meats pressure cooked to tenderize", but in my head, those are more solid so I am a bit shy of that just yet.

Even though I will not have to be on a strict vitamin regimen, I am taking Biotin, Thiamine, a multi (gummy), Omega 3 (gummy), B-12 & D + Calcium (sublingual tabs).

I'm feeling pretty back to normal most of the time although I get easily tired out. I am used to having an extremely high level of energy so that kind of stinks, but I know it will get back up there. Everyone seemed so surprised that I was back at church, back in the singing groups, going to work, etc. I was not on pain meds for more than a day and a half at the hospital and once I stopped the IV, the pain was manageable. The nausea went away after two-three days and I have not thrown up at all. Many MANY people have. I hate throwing up so I am trying to be super cautious about when to STOP eating. My little stomach is now exactly 4 (FOUR) ounces. Anything I've eaten was only one or two and then I feel full. It's still healing. I'll prob have to eat little small meals several times a day eventually. Today, I had my protein shakes and vitamins first and then took an applesauce, a pudding, a cheese stick, and some turkey with me for the rest of the day until I can have some veggie soup tonight after choir. Before you judge, we are SUPPOSED to be having snacks and those (applesauce, cheese, pudding) are on the list!

Here is a before picture and then a picture from a week and a half a go. I cannot tell too much difference yet. My 3X clothes are now loose and I've lost 35 lbs so far. This weekend, I'll post some more pictures of before and after. I'll try to make a collage of sorts. The cool thing is that I am wearing a dress I haven't been able to wear in years and now I'm at the weight that I was when I moved to NOLA eight years ago! My starting weight was 270. I don't mind sharing that. My current weight is 235. Cool! No amount of exercise or fad or legit dieting was ever able to get me this kind of change.......and I've been trying off and on for 30 years. Some part of me says "wow, I could have just stayed on a liquid diet for a long time" and the other parts of me remind myself "I already did that and it ALL came back the minute that diet session stopped." This time, it is not a diet. It's a continuation of my mostly healthy lifestyle, PLUS the surgical help of restricted portions. Oh, and surgery is N O T the "easy way out". Think what you want, but if you say that to me, you might want to know I can throw a pretty solid punch. ;-)

Night bef surgery: 257                                             In this picture: 248







Springy Goodness!

I'm feeling awesome today! First, it's a lovely spring day here in NOLA and I'm feeling caught up on my grading stuff (so far). I'm super happy that I found some interesting material on the life of St. Peter to look at as a result of my first spiritual advising meeting. Seems ole Pete and I may have a few things in common :-) I want to find a nice blanket of clover in City Park and just go read. Unfortunately, I can't do that until at least May 23/24l, but I WILL go do that!

It's also been exactly a week since I began the two-week required pre-op liquid diet and I am down ten pounds! I'm happy that my liver will hopefully be in mint condition for the procedure. Part of me says "Hmmm, if you're suddenly losing so well, then why go through with the procedure at all? Why not just stick to this liquid thing for an extended period of time and then all will be well and you won't have to be without a normal stomach." Then, the other part of my psyche reminds me that "I've tried this before, perhaps not so severely....but.....
been there, done that......and then it all came back on plus more over time".

My recent annual check-up was ridiculously good.....BP 118/65, blood sugar perfect and all that jazz. I just have the feeling that it will catch up with me at some point because I am so far past the point of caring about dieting. Two years ago I had officially given up after six months trying the Aspen Clinic program, my "last resort". When I say gave up......I mean GAVE UP and from that point onward, I stopped caring, measuring, reading labels, exercising more than a day or two each week, and started enjoying eating more. That's a slippery slope I tell you!
I digress.....The recent check-up was another excuse to ask myself "Why I am I doing this again?"

I'd say I have a minor case of the pre-surgery jitters - even on this day full of springy goodness :-)

I will say that I do feel really supported by friends, church staff friends, family, and colleagues. That's a nice feeling :-)

My Choice for VSG Surgery: ENDOBARIATRIC

An Easy Decision

I am going to have my VSG surgery at the Endobariatric clinic with Dr. Guillermo Alvarez in Piedras Negras, Mexico. It was an easy decision to make after months of research and literally years of insurance issues etc. and I am fully confident that this is the right place for me. The more I see, the more I feel this way.

The very first reaction of many of my friends and colleagues, however, includes:

1. Facial contortion with raised eyebrows
2. A gasp
3. The questions: Is it safe? Are you sure about this? Have you looked into this place?

Really?
AS IF to imply that I haven't researched this or that somehow they have insights into the clinic they've never heard of. It's interesting how some are open-minded about it and how others absolutely feel they know more than I do. Now, I totally do understand that they mean well, but seriously.... I even asked one person who was acting as if I were crazy, if he had ever been to Mexico or if he knew what kinds of medical instruments the clinic used. "No" on both accounts. I am grateful that folks worry about my safety, but I will be fine! It's a FANTASTIC clinic with a world-reknowned doctor at the helm.

We've all experienced naysayers throughout our lives at one point or another. I have two things to say about that:

1. The last thing we need when making giant decisions and lifestyle changes is people undermining the validity of our choices. Be more supportive and less critical instead! They often do not realize the shoes we wear or how difficult our paths may be. It happened when I went for my MM, my DMA, and when I made the decision to take a job in Milledgeville, GA and happened a LOT from TONS of people when I decided to move to New Orleans after hurricane Katrina. Moving here has actually proved to be one of the absolute best decisions of my life. Some folks went as fars as to say that New Orleans was a worthless city and that I'd be throwing my career away if I moved here. BREAKING: They were wrong.

2. “When someone tells me "no," it doesn't mean I can't do it, it simply means I can't do it with them.”  - Karen E. Quinones Miller

A couple of years ago when googling VSG and other types of bariatric surgery, I found tons of helpful blogs, YouTube videos, and forums. One such forum was the VSG SleeveTalk site. It didn't take long to see Dr. Alvarez's name popping up along with mentions of surgery in Mexico and whole discussions of medical tourism. I visited hs website and was immediately impressed. In addition to that, it was the tons of positive testimonials (written and in video) from real people who had undergone VSG surgery with Endobariatric.

One of my reasons for choosing Endobariatric is that VSG surgery is not covered by my insurance company. I did research into this for several months and talked about it to state level and national level company employees about how to file a petition or how to file an appeal.
I did not want to do either. I was one of the first people to apply for the office of group benefits Head's Up program with Pennington Biomedical Research Center and OGB Partnership Benefitting Louisiana (which is an awesome start for state-level study of bariatric surgery and its effects). This program consists of a lottery and they will do 400+ surgeries over a period of several years. So far, I have not been chosen for the bariatric lottery and frankly, I am tired of waiting.

I took nutrition classes at a bariatric clinic and then paid $350 out of pocket to have a consultation with the surgeon directly. He basically gave me eight minutes of his time and was nice, but very busy, shuffling papers and the like. I noticed he gave me little eye contact. I FREAKED OUT and decided that I was NOT going to try and raise or borrow the 17-18,000 $ needed for this clinic. Instead, I'd save for a trip to Mexico!

SAVING. WAS.  HARD.
This past year, I chopped my paycheck by about $1,000 per month and had to move to reduce my rent etc. Worth. It. Now, I have the $8700 for the whole surgery package which includes two nights in hotels and transportation (two hours each way), and the care and concern of a staff that has already proven several times to be excellent and on top of things.

My doc here in NOLA will do any follow-up and she has had several patients go through bariatric surgery. One of them also went to Mexico.

Y A Y !  I'm excited Y'all :-)

WLS Journey IV - Surgery Scheduled!

TUESDAY, MAY 14th is the day! It's exciting to have this dream become a reality after such a long time. A week after scheduling the surgery, things got a lot more real - I paid my deposit!

I made sure to schedule the surgery for after the semester is over, but at a time when I know I'll have a great deal of work to do via computer. Grades are due that morning so I know that I will have something to help distract my mind get through the few days beforehand. I will be on a liquid diet for two weeks prior to the surgery date. This is to shrink my liver and ensure that the surgeon can reach the stomach easily. It will also add to the weight loss!

I will be teaching in Innsbruck, Austria this summer for seven weeks (more about that later)and want to have the surgery at least a month before I fly there. I will still be learning how to handle my new stomach size, but I will be surrounded by fresh markets and an easy / touristy way to increase the walking that I already do.

Some thoughts that recently occurred to me:
- I will be able to fit into those STUPID SMALL school desks better.
- I've spent 30 years fighting a battle against obesity....with whatever years I have left, at least I will have a tool to help me fight it better
- I WILL ride horses again. I used to train horses, racehorses actually (trained two for the Hialeah stakes in Fla.), but I've been avoiding riding for YEARS because of my weight.

50 days until surgery!

WLS Journey Part III - Types of Bariatric Surgery & What I'm Having

Types of Bariatric Surgery in a Nutshell

Check out each link for detailed images and info.

Lap-Band / Gastric Band - This involves putting a band around the upper portion of the stomach to restrict the amount of food you can eat. The band is inflatable and those who have it must receive saline solution fill-ups periodically. It's considered a minimally invasive procedure and is both adjustable and reversible.

Gastric By-pass - This both reduces stomach size and re-routes a segment of stomach and small intestine. The segment containing digestive juices is attached to the food-bearing intestine closer to the large intestine. There are several different kinds of bypasses.
More info here: http://en.wikipedia.org/wiki/Gastric_bypass_surgery

Vertical Sleeve Gastrectomy (VSG) - In this surgery, the size of the stomach is drastically reduced to a sleeve and the remaining portion is removed.
More info here: http://en.wikipedia.org/wiki/Sleeve_gastrectomy

Duoenal Switch (biliopancreatic diversion with duodenal switch (BPD-DS) - This surgery both reduces stomach size and re-routes a substantial portion of the small intestine, creating two separate pathways and one common channel.
More info here: http://en.wikipedia.org/wiki/Duodenal_switch

Info from the Mayo Clinic http://www.mayoclinic.org/bariatric-surgery/types.html

 

 

I have chosen to have the VSG procedure. For me, I feel that VSG is the best choice. I know a few people that have had this same surgery. I know two people who have had lap-bands and three who have had gastric by-passes. Each of my friends is happy with his/her decision and has had amazingly successful results!

 

There are benefits and complications to each surgery. It will take a long time to get used to eating with the new stomach size and temperament, but I think that no longer having the portion of the stomach that produces the hunger hormone Grehlin will be useful. I also believe that if I were to get the Lap-band, I would be able to "cheat" a bit by not going in regularly enough for saline fills. I have read about that happening. I have also read many accounts of the malabsorption that can sometimes be associated with gastric bypasses. In addition, many people who have the bypass procedure, have experienced what is called "Dumping Syndrome"

 

There are TONS of helpful websites and blogs out there about bariatric surgeries. One I've come to enjoy reading is the VSG Talk forum.

 

I've also found tons of YouTube videos helpful in seeing real people discuss and share the problems and the triumphs of each of the surgery types. I'm often struck by how much has rapidly developed during my lifetime. From typing a paper on a computer for the first time during my Masters degree to finding anything at any time on personal devices practically anywhere - this amazes me!

 

I believe that I should have this surgery. I'm quite ready to not have to deal with the weight struggle which has tormented me most of my life. I'll have a new struggle and new results!

 

Cheers!

 

 

WLS Journey Part II - Going for It.....and Insurance Land

I decided in May 2011 that I really wanted to go for it.

I had decided this before, many years ago, but did not make any moves because it was prohibitively expensive. Now, in the middle of my career, I realized it might yet be a real possibility. So, I attended a Bariatric Seminar at a local hospital. They were very nice and it was informative. I was shocked at how many people were there. There were some for whom I realized this surgery would be a life-saving event. I kept the information, but did not follow up with them right away because of the high cost.

Summer came and went. I read Mindful Eating by Jan Bays. I tried new meals. I walked City Park like a fiend. I traveled to Brasil and walked holes into my shoes, literally. I had to throw them away. I hiked around Igacu Falls on both the Brazilian and Argentine borders. I read blog after blog. I drank a bazillion gallons of water! I read articles and websites. Then, in the fall, I started talking more about it with friends from far and near who have had various weight loss surgeries. I learned lots of practical things related to surgery and recovery that I hope to work through with the same sucess they have found.

Two of the blogs I like are:
The Incredible Shrinking Girl http://incredibleshrinkinggirl.com/ and
Living After Weight Loss Surgery http://livingafterwls.blogspot.com/
I have found HUNDREDS of blogs about people's personal journey with WLS. I thought to myself: "Why not?!"

In February 2012, after tossing it around forever.....I made the second part of the decision to have weight loss surgery (WLS). Want to know what that part is? It's commitment. When I say this, I mean commitment in the sense of a deep, abiding, personal dedication to the preparation, process, and life afterwards. It is a work in progress, but I know I can do it!

Some of my close friends who have had weight loss surgery have helped me - a LOT and I am eternally grateful to them. I will need their encouragement and that of my other friends through the coming months.

From December 2011 to February 2012, I exhausted my health insurance options, making tons of calls, filing petitions, and learning that no matter what, none of the insurances offered would cover bariatric surgery - even with medical letters of necessity and references. It was recommended to me by a very nice man at the national office of one of the agencies, that I try the Head's Up program with the state Office of Group Benefits. I filed the application online to be chosen by lottery for elective bariatric surgery which would be 100% covered. All of the people with whom I interacted (phone screening, random questions from me, letter-writers) have been SO NICE and VERY helpful, but it's been over a year and I haven't been chosen. The dates of the program and the numbers of surgeries have been changed and I wish the very best to those chosen, but I won't wait any longer than this May.

The next step for me was to attend bariatric surgery nutrition classes (again, as I have done so in the past) and choose a surgeon. I don't know why I thought I should do this because the surgery package was about $17,000 (which I didn't have and was unwilling to borrow). I ended up completing the courses, meeting with other prospective patients, choosing a surgeon, paying $350 out of pocket to speak with the surgeon one-to-one, and then walking away upset, terrified, and angry. Why? Well, the surgeon gave me nine (9) NINE minutes of his time and in fact, he was sifting a stack of papers and not making eye contact. I felt as if I was wasting his time and he did not volunteer much info, rather, he answered when I asked a question and after the nine minutes stopped.

Lucky for me, I was simultaneously doing research on another surgeon and reading blogs

In my next post, I will describe the type of WLS I'm having and how I found my surgeon!

My Weight Loss Surgery Journey Part I - A Little Background

WARNING: Weight loss surgery post (WLS).
No, this is not permanently turning into a weight loss blog, but since it's my personal blog, hey, I decided to use it as a posting place. I sincerely hope that my ponderings and ramblings will help someone on his/her journey. Even if no one ever reads this except for me, it feels awesome to get it out into the universe and therapeutic to write about it. This first WLS post contains a bit of background and a wee bit of ranting :-)

Yep....I've tried tons of diets.....since I was 11....yes.....11 years old. Believe it or not, I can actually still hear the doctor's words as he told my mother that I was fat and needed to go on a diet.....as if I were not present or somehow didn't understand what it meant.

Yep....I do exercise, though not religiously and not enough. Nope...I don't sit around eating cakes and pizza or snack on bowls of Dixie Crystals.

I am only a bit of a "grazer". (Love the world map on this cow? LOL!)

Weight Watchers? Yes, twice. Low Carb? Yes. Medi-fast? Yep. Even Opti-fast and 6 months of eating ONLY puddings and shakes (blech). Slim-fast? Of course. Salads only? Yes.

Exercising with all or some of these? Yes: in recent years, just walking, but previously, I'd walk 3X per week and play tennis 2X each week. I used to be on a swim team (and won awards!) and I used to train racehorses (In SC, but for the Hialeah race track in Fla.) As a teen, I biked 20 miles per day.

The most successful thing I ever did was exercise and eat a healthy diet of about 1200 -1600 calories per day and I would stop eating after 2:00 p.m. every day for a year and a half. I lost 33 lbs. I just could not keep that going. Another time I lost weight was when I was hospitalized for food poisoning. Not the most glamorous way to shed lbs. and certainly not on purpose.

Doc says I am healthy. The last eight times they took my blood pressure, it was 110/65. A couple of times, including today, it was 102/65. That doesn't mean too much, but it's not an unhealthy pressure. I admit, sometimes, I do eat the wrong things and I eat late sometimes and ok, I don't eat enough fruit. I have a feeling that I'm not the only one. So why should it make me so unsuccessful? Everyone seems to have some advice which he/she thinks will work for me or that they assume I have not tried. Because I am large, many people automatically assume that I'm either lazy, constantly eating/drinking largest portions, complacent, not energetic, and that I am somehow hiding behind myself on purpose....that I psychologically "want" to be a certain heaviness.

Diabetes. I am extremely worried that this will be my fate unless I do something more drastic than dieting and exercise. To again be clear, I have no medical issues except morbidly obesity.......yet.  I know it will catch up with me eventually. So, after twelve years of loosely thinking about and then dismissing weight loss surgery, mostly due to lack of funds, I have spent the last 28 months, significantly re-studying, discussing, pondering, and more actively pursuing this option. The decision to move forward came after two major efforts which were, sadly, ineffective. The first, was the eight weeks I spent abroad in 2010 and teaching for UNO in Innsbruck, Austria. The second was becoming a patient of The Aspen Clinic for six months and losing about seven pounds.

While in Austria, I ate a daily, decently-balanced cafeteria lunch and I shopped for veggies and soups from the market. Occasionally, a pizza was had because it was thin, and cheap. I walked a mile to and a mile from the university every day and most days, walked several more miles while exploring the city. One trek had me hiking the Obergurgl glacier which was eight miles for that day - a fairly decent portion of which was UP . On my weekends in Italy, all I did was walk, constantly, take pictures, and swim. In the town of Rovereto, I did almost six hours of hiking/walking and then realized I'd missed the bus and had to walk another two miles back to the B&B. The pool was a personal rule of mine -"don't stay at this B&B unless it has a pool."  I had tripled my exercise and that summer - I lost one pound. ONE. The Aspen Clinic had me on an appetite surpressant and I only took it because while I was already eating a balanced caloric intake w/ colorful fruits & veggies and exercising on my treadmill, I was hoping that it would make me forget to eat and that I would drop pounds... WRONG. I lost seven pounds in six months. I had lost more weight than that before....what was different? My age....I'm fairly certain. So, after those two experiences, I gave up again and when I say that, I mean  G  A  V  E    U  P.

You know what? It's BIGGER than eating. This is a problem I've struggled with since I was eleven. I'm 42 now so that makes 31 years of my life that I have been disappionted with this 90% of the time for something that I have come to believe is honestly related, in part, to my heredity/metabolism. Why is it a problem if I'm healthy in spite of the weight? It has taken its toll psychologically and emotionally at times.  I am positive that at some point, health-related issues will catch up to me. Some of you have walked this road. Some of you haven't, but you can probably understand it.

I will elaborate that having experienced real examples of being considered less important, less attractive, and less intelligent by members of the general populus creates a root system of low self worth. These are my shoes. How can I explain to you what it was like in grade school? How can I explain what it's like to feel invisible (restaurants, stores, career)?  How can I truly explain what it's like to see or receive sighs of disdain in airplanes, buses etc. when someone has to sit next to an oversized person, or what it's like to not be able to cross your legs anymore? How can I explain what it feels like to see that someone is grossed out or uncomfortable that you might like them / be interested in dating them, regardless of whether you actually were interested? I cannot. You just have to trust me on this....it's not pleasant. It can make you crumble and doubt everything that is good about yourself. Luckily, I'm happy to say that, believe it or not, I've overcome much of this through the years with great friends, humor, success in grad school and an awesome  career path and I am a very happy person!  In fact, sometimes I literally wake up smiling or laughing at something silly. I love my jobs and love my life! I definitely know how to have fun and have certainly not avoided travel just because I'm by myself or because I'm overweight. Still, weight loss surgery (WLS) will be part of my personal process at this stage in my life and I am really starting to look forward to this journey! In fact, after years of research, reading, and prep., I am downright excited about it!

In my next post, I'll share what I have done to prepare for this surgery, insurance land, and going for it!