Good morning! And what a lovely morning it is! I am finally feeling more like myself!!!
This morning I can report that the vertigo is gone, the rumbling has quieted, the fatigue has relented, I successfully returned to work yesterday and, get this: last night I slept over EIGHT HOURS! Whoot! The sleep alone is cause for celebration, I can tell you.
I still cannot manage to get two full protein shakes down in a day, but I can get one and a half and I’m working on two, just easing up on it by adding vanilla protein shake to my decaf coffee instead of creamer. I am conscientiously getting my 64 ounces of fluids in every day and am taking all the supplements I’m supposed to. In theory, I can add some soft foods this week, but I’m really fearful of rocking the boat at the point and may wait until I have gotten comfortable with drinking at least two protein shakes a day.
The biggest struggle I still have is with the anesthesia brain. SO FRUSTRATING! I have the attention span of a goldfish and it’s really getting on my nerves. Seriously, my mind is a pinball bouncing between thought bumpers then occasionally rolling around aimlessly. It’s ridiculous. I know that time will take care of that; however, as I’ve told you before, patience is not my forte.
This morning, I went for my first walk in several days. I walked only half a mile, not a full one. I don’t want to get ahead of myself again. This walk saw me walking faster than before and paying more attention to the mechanics of my body. I tend to sway my back when I stand or walk; so, this morning, I concentrated on tucking my butt. You wouldn’t think that would be that difficult, but when you have the attention span of a goldfish, it’s a constant internal litany of “tuck your butt. tuck your butt.” I also tend to be slew-footed, particularly with my left foot. So I was also reminding myself to keep my toes pointed forward. The internal chatter, then, was more like, “tuck your butt, tuck your butt, toes to the front. Tuck your butt, tuck your butt, toes to the front.” With a slick guitar riff, we could have a real hit on our hands with that, I’m sure.
The first week of this experience was not easy, not gonna lie. I’ve been through worse, but it was harder than I expected. The second week was no picnic – again, because I underestimated how difficult recovery would be. But this third week is starting off pretty nicely, I have to say! I am feeling much, much better – more like myself. I feel like I am returning to my center and getting closer to plumb.
My recovery has been going really well. Incredibly smoothly, actually, Too smoothly. I say that because the ease of my recovery allowed me to forget that I had major surgery. My mind might have forgotten it, but I can tell you that my body had not.
On Wednesday, I went back to work at my full-time job. With that job, I work at a desk from home; so, no driving, no lifting, no straining…well, other than mentally. With my post-op brain fog, I struggled to pay attention, but I did get some things done. I wasn’t nearly as productive as normal, but I got a good start. Wednesday was also the first day that I was allowed to add protein shakes back into my diet. It took me nearly 45 minutes to drink the first one and everything went just fine. I drank the second one at the end of the day and, again, took about 45 minutes to consume it. Everything was not fine.
Well, hang on. That’s not true. It was fine for about two hours. Then it was SO not. I began to run a low-grade fever, to have some indigestion, and to have some abdominal discomfort. My temperature never went into the range where the clinic told me to call them, but it got close a couple of times. I emailed them with a timeline at about 1AM, then called at about 8. Without going into all the gory details, I decided to take the rest of the week to rest and recover, and (at the nurse’s direction) to take the shakes back out of my diet. While still moving around, I decreased the distance of my walks. I think I was just going a little too far, a little too fast.
Frankly, even though I was miserable and slept little Wednesday night, I don’t know that I would have tapped the brakes quite as hard had I not seen an article about the death of Valéria Pantoja. She was a Brazilian beauty influencer. To be honest, I’m not really the demographic of any “influencer” however, this woman was only 30 years old and was recovering (allegedly) from bariatric surgery. As I mentioned in an earlier article, any surgery is dangerous and should be treated seriously and with respect, as should the recovery process. Reading about that young woman reminded me that I needed to take better care. I don’t have to do it all in one day. So, I took a breath.
I finally tried another protein shake at about 2AM. That went down okay; but, at 2PM, I was able to drink only half of that one. Still, after the one at 2AM, I slept for seven uninterrupted hours! That was the first time since surgery that I’ve slept that long and it was just wonderful! Because the afternoon shake didn’t do as well, I chose not to finish it. The important things to get into my system daily are the two liters of clear liquid. So, that is my focus.
I tapped the brakes on the shakes and walking, but I’m letting off the brakes a little at a time until I can get back up to full speed ahead.
Crucial note: I am not a doctor, nurse, or Healthcare professional of any kind. I am a patient, volunteering information about my experience in the hope that someone like me might find it helpful. I am not advocating bariatric surgery or weight management by any means. For those kinds of decisions, you should always consult professionals. Never base any aspect of your health on the opinion of a stranger on the internet.
I grew up in south central Mississippi, about 2.5 hours travel time north of New Orleans. Until 3rd grade, I went to a Catholic school where (I believe) all the nuns were from Louisiana. I’m not cajun and, in spite of having lived in New Orleans for nearly 3 years, would not even claim to be a New Orleanian. I have a tremendous amount of respect for those people and their culture. Too much respect to claim to be one of them. I’m just a girl from Mississippi they let hang around for a while.
My father was a big fan of the culture, particularly, the cuisine. He quoted this man Justin Wilson as long as I can remember. And while this video doesn’t have him saying it, I remember Dad starting every gumbo (and he made fabulous gumbo) in his best Justin Wilson voice saying, “First, you gonna make a roux.”
So, on Tuesday, the surgical team made a roux….outta me.
The procedure I had is called a Roux En Y. Harkening back to Ms Julia King’s French class in high school, I have been pronouncing that as rooz-en ee-grek. As we do in the States, though, we say things however we want to (I’m looking at you Versailles, Kentucky, Cairo, Georgia, and Milan, Tennessee – ver-SALES, KAY-roh, and MY-lan, respectively). Although people around me kept saying “rue on why,” it took me an embarrassing amount of time to make the connection.
ANYWAY, if you want to check out the above link, you can find out what they do during the surgery. I had some concept of that going into it, but didn’t really have a full idea of what it was going to mean coming out on the other side. I have that idea now, though, I can tell you for true!
Patients are not going to have the same experiences with any surgery. And the center knows that; so, there were some possible post-operative issues they didn’t mention to me prior to surgery. I suppose there is always the caution of not wanting to suggest a condition that a patient might not experience without the suggestion. And because I may be writing now to someone thinking about having this procedure, I won’t go into everything here. I don’t want to suggest anything, either.
I will, however, mention one thing that is extremely important to be aware of and wary of – post surgical depression. I had read about the risk of it prior to surgery; but, I really didn’t consider it. After all, I’ve had several surgeries before and it’s never been an issue – until now. This time, it was a big issue. There are likely several contributing factors that I will share with you in case you are considering this surgery and you have some form of depression.
General surgery anxiety. Anesthesia carries a risk. Any patient being put under runs of the risk of not waking up. It’s a very small risk, but it’s there.
Sharply decreased stomach size. If, like me, you take any kind of extended release medication, you’ll need to talk with your doctor about it. Nothing is in your stomach pouch long enough for an extended release to work. Your doctor will talk with you about options.
Low blood sugar. As I’ve said, for the ten days prior to surgery, I was drinking clear liquids and protein shakes only. My caloric intake was less than 800 calories per day. My system did not handle that particularly well when it came to mood. If you have a close relationship to someone with diabetes, you know they get cranky when their blood sugar falls. Hell! We all do! Otherwise, you would have no idea what I mean when I say that I’m hangry.
Disrupted sleep patterns. Not all bariatric surgery patients experience sleep loss. I have and I continue to. On average, I sleep for about 90 minutes at a time and am then awake for several hours. I’m not sure why this is and, like I said, not everyone goes through it; but, I certainly am. Sleep deprivation is a well-documented cause of mental distress.
Dependence on others. I was finally released to drive yesterday; however, due to some on-going light-headedness, I have still not ventured out. For a woman who does most things for herself, this is difficult to take. I am not safe to drive yet. I’m not allowed to lift anything over five pounds. I cannot do chores like vacuuming or taking out the trash. It is absolutely maddening.
Confusion. Anesthesia has lingering effects that can result in confusion or an inability to focus on anything. An inability to focus can quickly become general disinterest in everything, which is a double first cousin to depression.
Hormones. Estrogen is stored in subcutaneous fat cells. Rapid fat loss results in rapid estrogen release. During this first week, I have lost 13 pounds. Surely some of that was visceral fat that does not store estrogen but more of it was likely subcutaneous fat. I’ve heard various people describe it as going through puberty again or through menopause again. Regardless, raging hormones are just not a good time. One member of my team described it yesterday as a “vibe.” I think of Vibes as involving flowy clothing, Jimmy Buffett songs and weed. Lemme tell you, sugar – this ain’t that.
So, we have some potential contributing factors, What are we going to do about them?
Choose the best facility you can for your procedure. Read reviews, but be sure to keep a grain of salt in there and remember that people are more likely to complain loudly than compliment loudly. Check the number of procedures they have done and how your surgeon handles each one. All surgery carries risk. Just know that and find the best team you can.
Get ahead of it. Talk to your psychiatrist ahead of your surgery so that they can be on the alert with you and can be working on a plan with new meds or therapies before you need them.
Prepare. For my first week after surgery, I was allowed to have clear liquids only. Any flavored waters, gelatin, or frozen pops had to be sugar free. However, I could also have bone broth. That may not do much for your blood sugar, but it will give you some added nutrients. I was also allowed to have protein water. Our bodies don’t break down protein as quickly as sugar or carbs; however, they will convert protein into energy. I got some Oath protein powder that mixed into water. The strawberry-kiwi flavor was good and gave me 20 grams of protein in a 16 ounce drink, helping to level out my blood sugar.
Sleep when you can, but start moving. This week has felt a lot like being a new mother; but, as a friend said, I’m both the mother and the new baby. If I’m overwhelmingly sleepy, I’ll take a short nap. However, if I’m not doing anything but sitting on the couch all day, I’m not likely to get tired, am I? My team recommends walking a little every hour (given that I’m consuming 64 ounces of liquid a day, I’m up every half hour or so), and starting to walk for exercise. I take a walk around my neighborhood in the morning and again in the afternoon. My Amazon music service has been performing very poorly; so, I’ve switched to Sirius and am enjoying the Charlie Sexton Station as I make my rounds.
Talk to your caregivers. They are doing their normal thing and are not feeling the caged sensations that you are. Tell them. If your caregiver is not with you all the time, talk to other friends to perhaps set up a trip to the store or, at the very least, a good chat on the phone,
Give yourself grace. This is one of those things that takes time. The chemicals have to work themselves out of your system, Getting moving will help with that since that movement increases respiration, which gets clear air into your lungs. Also stick to simple tasks. Now may not be the time to take up jigsaw puzzles or crochet.
Buckle up. The hormones are there and have to find their own way out. Talk to the people closest to you to let them know that you are struggling with this and that sometimes you don’t even know you’re losing the struggle. The pimple-faced teenager in your mind is getting way too much time in control of your thought processes. My teenager is broody, selfish and can be truly mean. Yesterday, I saw a coping mechanism to deal with poisonous self-talk that I am starting to use. This woman said that she gave her hateful self-talk a name – Becky. (I haven’t chosen a name for mine yet.) Anyway, anytime she wakes and the mental self-abuse begins, she addresses her mind and says, “Becky, I love you, dear, but I have far to much to do today to get mired down in this with you.” “Becky, I’m quite busy now. We’ll have to talk later.” I really like that and am beginning to put it into my toolbox for better internal dialogue.
Clearly, lots to say today, right? My roux and Justin’s roux are two enTIREly different things; however, each involves taking existing ingredients and combining them in a way to make something wonderful.
I already hurt less and am making tremendous progress. This new healthier body and outlook is going to be the best gumbo I’ve ever had.
It’s Friday, or at least I think it is. My surgery was on Tuesday at some hideous hour of the morning and to say that my routine is upended is to put it mildly.
As I suspected, everyone involved in the process with Vanderbilt Weight Loss was wonderful from my pre-admittance calls right through to the anesthesia taking hold. Professional, but friendly and encouraging, they shared stories of how this procedure has changed their own lives or the lives of people they love. They all assured me that, although it’s a big and frightening decision to make, it has paid massive dividends in health benefits. I was glad to have the reassurance.
Then I began to wake from anesthesia and vaguely remember asking, “Whose idea was this? This hurts!”
Of course it was my idea and mine alone. I have received both positive and negative feedback from family and friends on my plan. Ultimately, though, any decision like this has to be the patient’s and the protocol in the months leading up to surgery ensures that it is. This protocol includes psychiatric evaluations, physical evaluations, nutrition counseling, behavioral counseling and support groups. This is a team effort to support every patient’s quest for better health.
It is important to remember that while it IS a team effort, bariatric surgery is not a panacea. The surgery will not do all the work on its own. I still have to do it. I have to stick to the diet as I return to being able to eat solid food (which won’t be for many days yet). I still have to get up and move. And, although I’m not moving very quickly, I am still taking Bon Jovi, Motley Crue, and Lenny Kravitz around the block a couple of times a day. As I heal, I will walk further and faster; but, for now, I am just moving.
Prior to surgery, I emptied my refrigerator, freezer, and cabinets of all food. I am stocked with sugar-free everything: gelatin, electrolyte drinks, bone broth, and popsicles. Everything else was sent home with friends to remove any temptation. And it’s a good thing, too. I don’t feel hungry, but I do feel like I should eat something. I still find myself at the refrigerator door, thinking that I’m going to have a little something. The only little somethings there are the things I listed above; so, I grab one of those options and start working on it slowly……very slowly.
At this point in my recovery, my stomach pouch holds just the tiniest amount of anything. Since I tend to gulp my fluids, I am having to pay special attention to the rate at which I consume them. Little baby sips. That’s what they told me to take and that’s what I’m trying to do. When I take my prescriptions, I have to wait five minutes between pills to ensure that I don’t create a blockage. That is super annoying as I am one of those people who throws ten pills in at once and swallows them down with a flood of water. Thankfully, I take those pills once every eight hours; so, it’s an annoyance just 3 times a day.
My surgeon does not use opioids if he can avoid it, which was fine by me. Extra strength Tylenol are working just fine and don’t have near the dangerous side-effects. One of my meds does make me very sleepy, though; so, dosing has been followed by dozing for the past few days, which is fine. My body is busy repairing itself and getting used to the new way things move.
All in all, I am feeling stronger each day, even if I am still tired and sore. I’m on the right path and feeling encouraged, even if I feel like my abdomen hosted a game of foosball.
Captain’s log: Day 429 of the siege. Day 429 with no food.
Okay, it hasn’t even been a week, but it feels like 429 days. Although I must admit that this morning I finally didn’t awaken dreaming of marshmallows with half my pillow in my mouth. Woof, Cotton mouth for sure. I’m still hungry, but I felt less panicky today.
Just a few more days to go and I’ll be there. I will still be on a liquid diet for a week or two after surgery, then only soft foods for another couple of weeks, then I can carefully reintroduce some things. Luckily, I work from home; so, if I create a problem during those reintroductions I am here by myself rather than amongst people having to deal with me.
As for the surgery itself, I’m not super concerned about that. I’ve had five other surgeries (yikes! that’s a lot!) in addition to several colonoscopies and a couple of dental surgeries. I’ve never had an issue although I do always tell them that I am a natural redhead. Apparently, some studies have shown that many redheads have some kind of gene mutation that makes us resistant to anesthesia. I always let them know because I’m not trying to wake up and have a chat during any procedure. I’m fine just taking my nap, thank you.
I am a little bit concerned about recovery. My only abdominal surgery was the better part of 20 years ago now. It, too, was laparoscopic and didn’t bother me much after a couple of days. I am hopeful that this experience will be similar, in spite of my increased, um, maturity.
As I said, I still won’t get to eat for a while after surgery and when I do get to consume anything, it will have to be in tiny portions. The only thing that makes me nervous about that is having to endure this continued feeling of being really hungry. I have been told by several bariatric patients that they didn’t feel hunger for a while and had to remind themselves to eat. Like they literally had to set alarms to make sure they ate. I’ve only ever had one time in my life when I would forget to eat. That was when I was a teenager and in love for the first time in that complete way that only teenagers who have never been crushed can be. I lost a lot of weight during those months.
So, I’m approaching this with cautious optimism that I will heal quickly and that I will not go back to feeling the desperate hunger I have felt for the past few days, not when I have finally rounded the corner and gone from Hulk Hangry to just David Banner Hungry.
As I mentioned in an earlier post, a childhood friend once implied that she thought that bariatric surgery was the “easy” way to lose weight. And, to tell the truth, I kind of thought so, too. But we were wrong.
This is hard. I have been closely monitored for several months on my weight and eating habits. That’s not easy whether you are preparing for surgery or not. But the part of this process that I really didn’t understand is probably going to be the hardest part for me – there are a great many foods that I will likely never be able to eat again.
For those of you in the back, let me say this loudly and clearly: I am not obese just because I eat too much. I am also obese because I really enjoy food. I like to cook and I like to eat. I love to bake cakes, loaves, and cookies. And I love to eat out, whether it’s a five star restaurant, a dive, or (my favorite) Popeyes chicken.
I am told that the kinds of foods and flavors I like will change after surgery, but even if they don’t, my stomach will be tiny and won’t hold much. And if I try to put things that are too sweet, too greasy, or too fibrous in it, I will likely trigger dumping syndrome.
For most of my life, I have known that certain foods (cole slaw, for one) will make me sick. You can set a timer: 20 minutes after I start eating whatever it is, I will be doubled over with cramps – my digestive tract preparing to empty itself violently and quickly. Because I know this, I am generally very careful what I eat in public and where I eat. Additionally, I always carry a small room spray with me in case the attack is severe. I never knew what this was called and I’m still not 100% sure it is dumping syndrome, but it sounds a lot like it to me. These attacks are painful and exhausting so I avoid those foods that I know will kick off an episode.
After surgery, I hear that most foods will kick off an episode; so, I will have to avoid almost all of my favorite foods for the rest of my life. That’s going to be really hard. Really hard.
Knowing that was coming, I had food funerals all last week, eating all those foods I won’t be able to eat after surgery. I had hamburgers, ice cream, sushi, pie, biscuits, eggs, barbecued pork, lemon icebox pie, banana pudding, bacon, sausage, and a whole bunch of other things, culminating in my final meal of fried chicken and mashed potatoes from Popeyes. And it’s not just food I have to give up forever. No more Diet Cokes. No more carbonated beverages of any kind. No alcohol for the next year – I don’t normally drink often; so, that won’t be a big stretch. It will be several months before I will be able to go out anywhere and eat, and I believe that holidays may be a nightmare for a while.
Most gatherings involve food or adult beverages of some kind. Those will be very hard to attend (especially the first few months) so my social life will take a hit until I find other things to do. I have already told my neighbors that my yard will probably look better this year than ever and I’m certain that I’ll get all my tools and hardware sorted. At some point, my social life will pick back up and, if I do like I did after The Great Reduction, my life will be more active and fuller. I will live larger.
But I will do that without my old favorites, the honorees at last week’s food funerals: Jeni B, Little Debbie, Ben & Jerry, Mrs. Butterworths, and, yes, Popeyes for they are all dead to me now.
I have not shared this with you, but over a year ago, I made a big decision. To quote Vivian Ward, “Big. Huge.” I had been feeling very hopeless about my weight and my apparent inability to do anything about it. Really hopeless. The kind of hopeless that sends a person with food issues straight to the snack cake aisle with a big grocery cart – none of that little basket stuff. Nope. Let’s load up. Nothing has helped; so, why bother?
Why bother?
Well, because I hurt. My knees, ankles, feet, hips, shoulders all yell at me on a daily basis. Every time I stand up, every time I roll over in my sleep something pipes up screaming. I don’t want to live the rest of my life like that. Granted, I have more life behind me than in front of me, but still. I don’t want to be crippled and that’s where I’m headed
So, I started looking at bariatric surgery.
After The Great Reduction, a life-long friend of mine said something about me having lost the weight the hard way. I hadn’t taken the easy way out by having surgery. I’ve thought about that a lot over the last 18 months. I didn’t actually start the process of moving towards surgery until about 14 months ago. And as I been involved with Vanderbilt Weight Loss, I learned that there is no easy way.
I have spent a great deal of time over the last 14 months keeping a food diary, learning to eat differently, and struggling with getting into an exercise routine. I still struggle with all of it. I still fail and still struggle with those feelings of hopelessness. I’ve lost 25 pounds. In over a year, I have lost only 25 pounds.
And the phrasing of that last sentence is a huge part of my problem. 25 pounds is a success. Could it be better? Of course. However, I didn’t gain 25 pounds; so, it could be worse. But 25 pounds when I’m still 100 pounds overweight, in my mind, is a failure.
Over 25 years ago, I had a counselor who pointed out my tendency to not give myself credit when I’ve earned it. More than 25 years ago and I still have to make a conscious effort to not belittle every achievement. I still talk to myself in a way I would never speak to someone I love. I still need help.
And I’m about to get a lot of it.
In less than two weeks, I will go in for gastric bypass surgery. I’m excited. I’m scared. But, mostly, right now I’m hungry.
My surgeon prescribed a liquid diet for 10 days prior to surgery. During this time, I can have protein drinks, broth, sugar free flavored water, sugar free gelatin, and sugar free popsicles. I’ve already started on it and, as you would imagine, it’s not easy. But, I am doing what I need to do to make it work. I have been taking care of some things on my honey-do list. (What do you call that list if you are both the list maker and the honey? To-do list? Yawn. Let’s work on a better name for that.) Whatever, I’m keeping my hands busy rather than just hanging out on the couch.
We’ll chat in the coming days about how this liquid diet is going, the things I’m doing it make it work, my fears for after surgery, and what actually happens after surgery. I am hurtling towards this life-changing event and I’d love to have you come along.
In the Roman Empire, it was said that all roads led to Rome and, I guess, it was true since the Romans built all the paved roads. If you build all the roads, you get to make up all the sayings about them. In the case of resolutions – whether new year’s, new Monday or post pig-out, I think that most roads lead to weight loss – or have the goal of it, anyway.
But there are lots of roads to get to that destination.
On Facebook, a friend posted a photo of herself holding a dress she wore when she was about 200 pounds heavier. In the text she posted with the photo, she said something about the gastric bypass surgery she had and how many people view that as taking the “easy” way out. Anyone who thinks that there is any easy way to lose 200 pounds is, not to put too fine a point on it, an idiot.
As I’ve said over and over in this blog, I share some of my own experiences losing weight, and the foods and habits that helped me do it. However, there are many different ways to lose weight effectively and healthfully. I constantly stress healthfully because for every solid program out there, there are three or four completely cockamamie ones. I’ve tried a few of them with limited positive results and a litany of negative experiences. Seriously, who wants to smell like vinegar all the time? So, again, as long as you lose weight in a healthful way, I say:
Go with what works for you!
For the seriously obese, gastric bypass or lap bands may be the only options that save their lives. Even with the surgery, diet and exercise must be altered to incorporate healthful habits or the weight loss will never be permanent. I know of a few gastric bypass patients who have gained all of the weight back because they didn’t incorporate the changes. The same thing is true for packaged food diets. If you don’t incorporate good food choices, portion control and exercise into your lifestyle, the weight loss will be only temporary.
Making those sorts of sweeping changes for maintenance is not easy, regardless of the method one used to achieve the initial weight loss.
Any real weight loss or healthful living program takes commitment, diligence, consistency and time. Let’s not forget about time. After all, neither Rome nor her roads were built in a day.
Thoughts about everything and nothing in an effort to be a better person than I was yesterday.
The Daily Doty 