What a Summer

We’re closing in on the end of the summer and what a summer it has been. I spent most of July dealing with health issues related to my son (they’ve lingered into August – let’s face it they will never completely go away, they will either be acute as they were in July or they will fade into routine as they were back in May and June). August has been primarily about getting my daughter ready to start a new school and she’s had about 4 hours a day of homework to do to cover the summer work the new school assigns. I’ve been trying to get some “me time” but that is nearly always an enormous and sometimes insurmountable challenge.

I anticipate that September will be a challenge as well. My son will, most likely, be starting a new medication that will require very close monitoring. My daughter will be starting a new school, with a hefty commute that will change the rhythm of our family’s day significantly. I will be going back to work, and my husband may be transitioning to a new role at work. So, you know, it will be normal for us, which is to say, chaotic. But by mid to late October I’m hoping for a lull that will give me at least a couple of days to myself to find some calm and focus that I’ll sorely need.

All this busy-ness has, of course, impacted my ability to focus on myself. My food and eating plan this summer has basically been to try to listen to my body, eat when I was hungry, stop eating when I wasn’t, make smart choices like low carb high protein foods, get in some fruits and vegetables when I can, and basically not over eat. It’s been easier than you’d think because of the help the sleeve gives. I sort of can’t believe I just said that, but I really just can’t eat that much.

A typical day looks like this:

• Protein shake or an egg for breakfast around 9 or 9:30am (I can’t eat when I wake up because of a medication that I take that requires I wait an hour to eat after taking it. That one hour inevitably stretches out as I get distracted by my kids and their needs.
• Lunch is usually around 1pm and it’s a rolled up piece of Swiss cheese with a couple of slices of deli turkey in it. (Some days lunch is a protein bar, which is shockingly filling.)
• I have a snack around 4pm of a cheese stick, or a handful of nuts, and a bit of fruit.
• Dinner is around 6:30pm and it’s been totally variable. I choose primarily chicken or fish and some veggies. But when we’ve been on vacation it’s also been some fancy restaurant food and I never eat more than 1/3 of what I’m served and I still go for chicken or fish. Sometimes, I just have a scrambled egg for dinner.

As of today I’ve lost a total of 43 pounds. I’m actually closer to my realistic goal of 165lbs than to my pre-op weight of 238lbs. This is a good thing. Although, to be honest, no one has noticed except the massage therapist I occasionally go to. I hadn’t seen her since last fall and when she saw me she couldn’t believe how different I looked. But no one else has said anything at all to me about it. I guess it’s hard to know why. Some people may be shy to say anything without knowing how I’d feel about it being mentioned. Some people may legitimately not notice. I don’t know. My husband, who’s usually so unbelievably supportive, was surprised when I told him how much weight I’ve lost. He said that obviously I’d lost weight but that he was surprised it was that much.

Oh well. I keep on trucking.

I’m trying to just get from one meal to the next.

Back and Forth

I was basically traveling from June 23rd until July 12th so I wasn’t around much. Then, literally within a day or two of getting back major stressors started happening with my son, again. He’s got special needs and I find that we can’t go very long without there being some sort of crisis. It absolutely destroys my ability to focus on myself when things get difficult with him. Honestly, it’s been difficult with him for a long long time. There have been some lulls but they are fewer and further between than the very intense bouts of stress.

But, he’s not really what my post was supposed to be about…

Anyway, this morning was my weigh in at home again. My husband has been complaining on and off the our bathroom scale is erratic and gives him wildly different readings back to back. This morning I got on our scale and after getting a reading that couldn’t possibly be true I decided to test it out and got on and off 10 times in a row (I don’t usually do this it was 100% about testing the scale.) I got six different readings in a three pound range over the course of 10 tries. So, I threw it out and went to buy a new scale.

I probably should have done some research first, it was a tiny bit overwhelming. But in the end I just bought one that seemed to be accurate. I got home, re-weighed myself and all is well. I mean 1.5 pounds in a week isn’t really “bad” but it’s not what I wanted to see…

This is a journey that is messing with my head, and I know this, and I know that it is happening, and I know that I can’t let it get me down, and I know that I just have to keep trucking. I’m 33.5 pounds down and that’s a good thing. That has to be my focus. Not the 1.5 pounds this week, but the 33.5 pounds down total.

33.5 pounds down.

Keeping Things Clear

I’ve been missing the past week or two because I’ve been traveling without my computer. Things have been hectic and stressful but I’ve been keeping to the plan so that’s a plus.

I was away taking my daughter to sleep away camp on my last weigh-in day. This month my monthly “anniversary” weigh-in day is today, Saturday. So I’m skipping Monday’s weigh-in in 48 hours and just breaking them up accordingly.

This, no doubt, is confusing. But here’s the deal: I’ve lost 4 pounds in the last 12 days so I’m going to record those as 2 pounds lost the first week and 2 pounds lost the second week (which ends in 48 hours).

Then, next week, July 10th, I’ll miss my weigh-in again taking my son to my mother-in-law’s for a long weekend. So there will be another 2 week gap between weigh-ins.

This is super boring, I know, but I’m writing it all down to keep it clear for myself and so the adjustments don’t mess with my head. It’s also all in the weight log to maintain my mental balance.

Bottom line, I’m down 29 pounds, and as much as I hate non-round numbers I’m willing to concede that this may be an accomplishment. Now I’ve just got to find my measuring tape and figure out what I’ve lost in the way of inches (that’s a monthly recording).

Barfing

So, yesterday wasn’t such a great day.

[Warning: this post might be a bit gross.]

On a whim my husband invited a family we’re friendly with to go out for dim sum yesterday to a place we’ve been many times and love. But, to be honest, I wasn’t thrilled with the idea of adding yet another restaurant meal to my week, nor was I happy about the idea of having to eat with people who don’t know I had surgery six weeks ago, but what the heck!

Things were basically fine during the meal because dim sum is chaotic and everyone is sharing dishes of food and no one could possibly have noticed how much I was or wasn’t eating. I ate about half the volume of what I would have normally eaten at home, and for no reason I can explain it made my stomach very uncomfortable. Towards the end of the meal I excused myself to go to the bathroom and I barfed. Although, it wasn’t really a standard “barf” because there was no stomach heaving, no retching, no nothing. I just felt like it was coming back up so I bent over and the food just sort of slid back up my throat and out. It was… odd. The food was all fully chewed and there was nothing that could have caused a blockage in the sleeve.

On the way home I told my husband what happened and that I wasn’t feeling too great. We got home and I went to the bathroom and the same exact thing happened again! About 15 minutes later it happened for the final time but this time there was heaving and retching. By that point everything was out of my stomach (all 5 tablespoons of food!) and there was no more barfing. But there still wasn’t any evidence of what could have blocked things up.

The rest of the day went pretty normally except I had some very mild heartburn and I was completely not hungry at all. I stuck to protein shakes for the remainder of the day to be safe and not tax my stomach. There wasn’t any pain, there weren’t any aftereffects, I slept fine last night. This morning I’ve had my protein shake and a slice of cheese and all is well.

I have no idea what made my stomach react like that. I hope this doesn’t mean that I can’t eat Chinese food ever again! But another day, another learning experience. Wow.

Nothing in Particular

My husband’s birthday was Thursday so I made a special dinner. Last night was a big outing with the whole family, which included dinner. Tonight I’m taking my husband out for his birthday and we’ll be eating in a restaurant. Tomorrow we’re supposed to be meeting friends for dim sum at 11:30am. (For the record I’m not the one who made those plans.)

After all of this I’m supposed to weigh in on Monday morning and I have to confess it seems like a huge joke to me to tell you the truth.

No, I haven’t over eaten. I haven’t even eaten anything that’s really so far off my food plan. I had the tiniest piece of homemade blueberry pie on the birthday. But other than that it’s been “protein, protein, protein” and some vegetables, my protein shakes, and bars.

But what amounts to four restaurant meals in the four days preceding the weigh in (not to mention the fact that I got my period nearly a week early yesterday) just doesn’t bode well for the results.

I’d consider skipping it altogether, but I’ll be out of town and no where near a scale the following Monday and I’m not missing the weigh in two weeks in a row.

But I confess I still feel confused and conflicted over the whole thing. As of last week’s weigh in I’ve lost 22.5 pounds. But I don’t really feel like I’ve lost 22.5 pounds. I feel, in my mind and in my body, that I’m the same. My clothes don’t really feel all that different, but maybe that’s because I’m still primarily in yoga pants while I wait for the incision by my belly button to finish healing. (More on that in a minute.) I don’t think I look any different when I look in the mirror, clothed or naked. Of course, the nurse’s remonstrations from my one month check up are still rattling around in my head making me feel like my efforts aren’t worth much. (It still doesn’t help.)

I took a few walks this week. Well, more like a couple. They weren’t long. But on at least two days I was able to get out and stretch my legs. It’s caused the pain in my foot to recur, which is very frustrating. I even bought new walking shoes, thinking the old ones had just worn out, but no, the daily foot pain is back. Maybe it will improve if I lose more weight. Maybe I’ll need to see a doctor. I honestly don’t know.

I think, that actually sums things up best: I don’t know.

I don’t know.

All I can do is one thing at a time, on day at a time.

Food Plans

I’m thinking of going back to the Dukan Diet. Not actually doing the whole diet as in the Attack phase etc., but more like following the basic principles of limiting food to proteins and vegetables with the maximum of one piece of fruit a day.

See, yesterday my son wanted to try Swiss cheese but when he took a bite of the slice he decided he didn’t like it. So, since it was lunchtime, I took the piece and added two slices of deli turkey to it and rolled it up and ate it. Afterwards, I felt as close to full as I have since surgery almost 6 weeks ago. It didn’t last too long, I was hungry again in about two and half hours, but it was the best I’ve had in a long time.

Then, last night I was really hungry after a relatively unsatisfying dinner and I ate another small bit of cheese with a slice of salami. Again, the hunger went away and I was able to go to sleep later without any serious hunger pains for the first time in six weeks. So, I think, even though I’ve been eating enough protein throughout the day so far, from the protein shakes and the protein bars, the concentrated real food protein from the Dukan style of eating, combined with being able to eat slightly more frequently on the Dukan diet, is what I may need to get through this.

It’s not much of a change, really, from what my doctor recommends anyway. His plan is always protein first, then vegetables and fruit, followed by any carbs last. The exception, of course, in both plans is the oat bran (well, my doctor’s plan said cream of wheat but it’s basically the same thing).  I’ve been doing it most days since my surgery anyway because it was part of the post-op plan and eating it for breakfast each day won’t be hard to do.

My biggest concerns are the loss of flexibility and that my doctor might get cranky with me for eating more frequently.

Being on a diet that blocks out a whole category of food is so much harder than being on a diet that allows everything but limits quantity. I mean, that’s one of the things that is a draw about the weight loss surgeries, your stomach size determines how much can and cannot be eaten and the smaller quantities do the trick for weight loss. It makes it so much easier to eat out, go to a friends house for a meal, go to a party, etc. I won’t say that I like the idea of having to once again cut out an entire food group, but let’s face it, I know that this approach works for me. 35 pounds in 5 months might not be up to WLS standards but for a more traditional approach it sure as heck worked. Right now I can’t see how combining it with the benefits of lower intake capacity will be a problem.

But there is the issue of my doctor. As I’ve mentioned, he’s gotten more rigid as he’s progressed through his career. I’m sure that is based on good solid experience and he’s right that when people mess with the established food plan they aren’t as successful. But, I need something that works for me and the plan his office gives out doesn’t seem to be working for me.

The idea of tweaking it, in some ways making it more strict, by following Dukan is giving me a sense of hope right now…

Maybe if I do this I can increase my success and hit the 3 month target after missing the 1 month target.

Maybe if I do this I can stop feeling so desperately hungry all the time.

Maybe if I do this I can feel more normal again.

Maybe if I do this I can stop feeling like this surgery was a mistake.

And let’s be honest, if I stop feeling like this surgery was a mistake I and bound to be more successful in the end.

I’m not trying to declare that I have all the answers here. I might go for two weeks, or two days, on the Dukan plan and discover it just doesn’t work. But I need to try.

So here’s the rub, my husband’s birthday is next week, we’re having family come stay for 4 days, and I’ve already planned and ordered the food for next week. Given the constraints of this I’m not going to be able to get started until Monday the 19th of June. Then, I’m going to be traveling from the 23rd – 27th. So, I know I’ve got a delayed start and I know I’ve got a challenge once I do start.  But, in this and all things, I have no choice but to do my best.

 

 

Visit With The Nurse Yesterday

The visit with the nurse yesterday was, as expected, awful. I cried most of the way home in the car.

The best moment: She told me that I didn’t reach their benchmark for weight loss in the 1st month, which is 10% of your total weight. That should have been 23.8 pounds for me and with the inexplicable 2 lbs weight gain between Wednesday and Thursday mornings my total weight loss was 17 pounds.

But that’s not how the appointment started off. It started with her asking me how it was going and I said it had been extremely difficult bordering on miserable. She asked how and I told her I was constantly hungry. She replied with, “up your protein, up your protein, up your protein”. I looked at her and said, “But you don’t know how much protein I’ve been getting in each day”. She looked confused, as though her formulaic response had never resulted in a response before. She said, “Ok, how much protein are you getting in” to which I replied, “60-70 grams a day”. She actually said, “Oh. Huh.”

There was an opportunity there, in that moment for her to make a switch out of her formulaic canned responses and move towards empathy and understanding by asking me more questions. She chose not to make that switch and spent the rest of the appointment telling me things without taking me, as an individual, into consideration. She actually even “explained” to me that sometimes people get into bad eating habits because they are trying to eat their feelings and that I should see their therapist. Then she explained to me what a therapist does.

I’M A THERAPIST!!!! I KNOW WHAT WE DO!!! I’VE ALSO BEEN IN OVEREATERS ANONYMOUS FOR 25 YEARS AND I KNOW WHAT EMOTIONAL EATING IS. I’VE ALSO BEEN IN THERAPY FOR YEARS. READ MY CHART BEFORE YOU COME IN HERE AND TALK TO ME!!!!

Of course, I didn’t say that, but between that and the “you’re not losing the right amount of weight” bull I just disengaged and stopped listening to her. At least I held back the tears until I had left the building.

The gal at the front desk is pretty awesome and she could tell I wasn’t doing well when the appointment was over. I had to schedule the next follow-up, for 3 months post-op, and when we were making the appointment we had the following exchange:

Me: “Now the next appointment is with the nurse too?”

Her: Yes. You generally see the nurse for all the follow up visits once your incisions are healed. You don’t see the doctor unless there’s a problem.

Her (Then, lowering her voice): Or unless you *want* to… do you *want* to?

Me: Yeah, actually, that would be good. Thank you.

He at least knows me and talks to me like I’m a person. I’ve been his patient for 12 years and he would NEVER tell me I wasn’t doing well enough because I was 5 pounds short of the “benchmark”. So, I’m seeing him next time. Which, I hope, will be better.

In the meantime, I can’t do anything except keep plugging away at this so that’s what I’m going to do. But jeez. That was unpleasant.

1 Month Post-Op Weight Loss

Today is 1 month post-op. I’m leaving in about a half an hour to go to my 1 month follow-up. No doubt that will be a whole other post because today I’m seeing the nurse and she is not my favorite person.

I weigh myself on Mondays. My surgery was on a Monday so it seemed logical to have it be my weigh in day. This past Monday I was away for the holiday weekend and used the scale there instead of at home. It said I weighed 219.5 and I rounded up to 220 because, well, it wasn’t my scale. I got home late on Tuesday so Wednesday morning, yesterday, I weighed myself to compare the two scales and I was 219. Seemed ok.

I had decided to also weigh myself on the 1st of each month (the “anniversary” of my surgery) to get a separate set of data to look at. So, this morning I weigh myself and get a scale reading of 221. I’ve gained two pounds since yesterday, despite following all the rules, sticking to under 600 calories a day, getting my liquids, vitamins, and protein as instructed.

The worst part is that for some insane reason last time I was at the surgeon’s for my 1 week post op the runner took off an extra 3 pounds from the scale reading “for my clothes”, which most certainly did not weigh 3 pounds. So, if I try to correct that today that will “show” that I’ve lost 2 pounds in 3 weeks, and goodness help me, I have no idea what sort of crap the unempathetic, fast talking, snotty nurse will give me for it. Ugh.

I’m also 100% hungry all of the time. All. Of. The. Time. My husband has been on a crusade to try to figure out why in the world I would be so hungry all the time after this surgery. His extensive research has lead him to suspect that I am experiencing something called “gnawing acid”. From what I can gather this is basically a type of “heartburn” that doesn’t burn, it makes your stomach feel hollow and empty and hungry all the time.

The treatment is to double up on medications to treat it from multiple angles at once. I take the Prilosec my doctor ordered every day. Now, I’ve added Zantac (which is a different med that works in a different way on the same problem) and I’m taking the maximum strength of Tums as well each day. I’m still hungry.

My doctor said it was “head hunger” which, I know head hunger and it’s not. My stomach is actually growling loudly enough that others can hear it.

My husband thinks it’s GERD so I’m taking the medicine. But again, my stomach is actually growling loudly enough that others can hear it.

Possibly stalled weight loss after only a month.

Constant hunger.

Constant exhaustion from the low calorie intake.

I had started to feel optimistic after I got back on solid foods. I wanted to feel optimistic. But I’m not feeling so optimistic today. I fear I’m broken. Just broken and this will never work. I fear I’ve made a mistake and I don’t know how to fix it.

Unfortunately, no one wants to hear that. Everyone in my life is being so positive and supportive that I don’t know how to say, “So I think this was a huge mistake and I may have doomed myself to a miserable situation of constant hunger and little to no weight loss.” My doctor certainly doesn’t want to hear it. I think he’s gotten jaded in the last 12 years since I first met him because despite his empathy he doesn’t seem to really believe in individual outliers anymore. Despite our good rapport I doubt I’m going to convince him that my failure is due to anything other than me not actually following the rules.

But I suppose that’s why I have this blog. It’s the one place I can be totally honest and not have to worry about what other people think. These are my OA “shares” in written form. Which, I suppose is something.

Onward.

Looking Up

Well, it’s day 19 post-surgery and it took until day 14 for me to start sleeping again. Those two weeks were really truly terrible. Not sleeping for that long felt like torture and it felt like I was losing my mind. 15 minute catnaps were NOT cutting it.

But I’ve been sleeping for the past 5 or 6 nights and it has made a huge difference.

It also made a huge difference that when I saw my doctor he gave me an updated post-op food plan. Now, I’m eating food that is both soft and moist, not just drippy liquids, and even though I haven’t been able to eat more than a couple ounces it at least feels like I’m the road to normal. Of course, the best part is actually that on about day 11 or 12 food started to taste mostly normal again. Not perfect, but significantly more like food than rat poison. The relief from that is better than I can express right now.

The heartburn finally went away yesterday. It was hurting like hell on Wednesday morning and I finally just ate some soft cheese and by the time I was halfway through I could feel it dissipating. I ate mostly dairy products on Wednesday including at bedtime a bit of yogurt drink. I drank some last night too and I’ve been feeling ok ever since. Thank God. I was really getting scared that wasn’t going to end. But now, at least I have a tool that works better than the omeprazole and Tums. Yay for low-fat cheese!

I have no idea what any of this is doing to my weight. I’d like to think I’m losing but I have no idea. Last week’s 2 pound loss was confusing and I genuinely don’t understand it. My calorie intake these past few days has increased from between 300-400 to between 500-600. I can’t get my head around the idea that 600 calories a day is too much to lose weight so I’m just going to throw my hands in the air and say, “I just don’t know but it’s better than starving and better than 2,000 calories a day” and leave it at that.

I’m doing my best to make the right choices. I realize that this surgery only works if I take control over what I put in my mouth. I also realize that much of what is preventing me from eating small amounts of junk right now is simply willpower, and honestly there is a toll that it’s taking. I do worry about what that’s going to mean in the long run but for right now I’m just trying to take the fact that I’m sticking to the plan as a win.

So that’s my mostly optimistic update.

Onward.

Confusion

Well I’m two weeks in and I’m not only feeling utterly miserable still, I’m confused as to why I’m not losing weight at the expected rate. I lost 2 pounds this week despite my caloric intake being painfully low. I haven’t eaten more than 375 calories in a day since the surgery. Based on my height, weight, and activity level with this level of caloric intake I should have lost over 5 pounds this week. But, instead I lost 2.

This is what I’ve been talking about for years: that there is something wrong with the way my body handles food. I eat next to nothing and still barely lose anything.

I know how this sounds, I do. 10 days ago I was complaining that I’d lost too much and now I’m complaining that I haven’t lost enough. I sound inconsistent at best and like a spoiled brat at worst. But come on, no one with the sleeve loses this little on such a restricted food intake.

On a side note the damn heartburn is freaking awful. It’s constant. I take the heartburn medication plus I also take a bunch of Tums everyday and it never goes away. The longer I go with an empty stomach the worse it gets. I had to get up about an hour after I’d gone to bed last night to eat a couple of spoonfuls of yogurt just so that I could lie down without the burning in my chest being unbearable. This was after taking the omeprazole and Tums.

Everything about this is awful. Sorry. I haven’t been able to be optimistic since this started. It’s not just that it’s so much harder than I expected, so much harder than 12 years ago, so much harder than the other surgery was… It’s that in my heart of hearts I really do fear I’ve made a mistake.