"Do, or do not. There is no 'try.'"

Day 60

Introduction

Fear not: today's entry is catching up on the last 60 days so is very long... I promise later entries will be more concise!)

What am earth am I doing here, starting a blog? Who cares about my journey? Maybe no one else in the world but me. But here I am... taking a leap into cyberspace -- wondering if I've set my privacy settings properly so no one can see this unless I let them... and then wondering who cares if anyone does see this? I've been thinking about this for a while -- weighing the pros and cons of a hand-written journal vs. one on the Internet. Cyberspace won.

What is this? I think this blog is going to be about my journey to a new physical being -- a stronger, healthier body. I wonder if it's going to get any deeper than that? I have spent a lot of energy shutting myself away from others -- is this just a way of building a window into the walls around me, or is it a way of opening a door so I can come out and others can come in?


"Do, or do not. There is no 'try.'" - Yoda, Jedi Master

Master Yoda's words of wisdom sum up the realization I've finally come to about my physical self. I can't "try" to be healthy anymore; I have to "do." After lots of soul searching I finally acknowledge that the first thing I have to do is lose weight -- and in a way that ensures I can sustain the loss.

After lots of research, I've decided the only way I can do this successfully is to completely change my physical self. And the only way I think I can be successful at this this time, once and for all, is with a Roux-en-Y gastric bypass.


The journey begins

This trip "officially" started several months ago with a visit to the endocrinologist (a wonderful man I might add). My weight had reached an all new high, exceeding a milestone I never wanted to have within my reach, let alone exceed. My blood sugar control was barely hanging on and I'm sitting there blithely thinking, "Guess I'll have to start upping my insulin doses again," when he pronounces I'm at the maximum dose he considers safe and removes the option. Bubble burst. I swore I had been "trying" to lose weight -- but I wasn't "doing" it. The increase from my prior quarter's weight was so great he thought perhaps I had a new condition to add to my seemingly endless list of chronic health issues. I eagerly embraced the thought and was sincerely disappointed when the test results came back negative. How crazy is that? To actually hope there was a problem!!

I have had doctors throwing weight loss surgery at me as a suggestion for years. I started listening to the thought a couple of years ago. The above endo visit put me over the edge -- time to "do."

So, my darling John and I went to a seminar about the procedure on Cinco de Mayo. We joked about having great Mexican food afterwards on the way to the seminar. We weren't joking by the time it ended. The surgeon was great -- concisely described the procedural options for weight loss surgery in good layman's terms -- concisely described the rewards and concisely described the risks. Death. Yikes. That's a term I understand at some level but really don't want to become intimately involved with yet, you know? That's what I'm here to postpone. The inevitability is inescapable, but I feel like my time's not quite up, yet.

We are given a bunch of hand-outs including a health bio and a checklist. I filled out the bio and sent it back the next day and then started the long hurry up and wait process they warned us of.

I'm going to start counting this journey looking at May 5 as day 1. That makes today day 60. They told us that "if we qualify" for surgery to plan for it to be 3-6 months out.


The checklist (my interpretation) - including status

1. See a shrink - get a sign off that you are not going to commit suicide when you have to totally change your relationship with food and learn how to eat all over again as an infant would learn. And oh by the way, no carbs. No alcohol. No alcohol? Not even an occasional glass of wine? No alcohol for 18-24 months after the procedure and then if you can tolerate it know you'll be a cheap drunk and 1/2 a glass of wine may well put you under the table. (Do I believe? Not at first! Denial!! Investigate and learn it's true. My sister-in-law had roux-en-y several years ago and can't handle a single glass of wine -- she can do one beer. Woohoo... and we used to be the margarita sisters! What a difference a little re-routing of the plumbing can make). No carbs? Yeah. Not for 18-24 months. Did you ever think about the fact that rice expands in your stomach as it's digesting? I never did... and lord only knows after going through all of this to bypass some 95+ percent of your tummy, you certainly don't want to expand the size of your new "pouch" as they refer to what remains useful. And then when you add carbs back later only allowed in extreme moderation -- better to try not to add back! Status: done.
2. See a nutritionist - notes above - need to learn how to eat all over again. Status: see today's frustrations below.
   
3. Lose 10% of your weight - you've got to be kidding. That's why I'm having the surgery! Then learn that the first thing in your body that loses size when you lose weight is your liver. Your liver has to be small enough for them to use retractors on through some of the 6 abdominal incisions you're going to have with your surgery to hold out of the way so they can get to your stomach and intestines for bypassing. If it's too big, you have to have open surgery greatly increasing risks and recovery time. Yeah, lose 10% of your weight. Status: done, but see today's frustrations below for caveat.
   
4. Get a cardiac clearance from your PCP (primary care physician). Status: see today's frustrations below.
5. Get a sleep study done. Status: see today's frustrations below.
6. Have a million blood tests performed Status: done, but see today's frustrations below for caveat
7. Have doppler ultrasounds of your carotid artery and your leg veins done. This one was a little of a surprise. That was until I found out the surgeon's had a couple of patients lately that had post surgical blood clots that almost killed them. As a matter of practice they give you blood thinners with the surgery, but if you have problems in these areas they need to know ahead of time. Makes really good sense to me now! Back to that I'm not quite ready to die yet thing we were talking about above. Status: done, pending results.
8. Have an EGD done - don't I sound cool throwing around these medical acronyms now? This one is short for esophagogastroduodenoscopy. No wonder they've shortened that! eMedicine describes this as "a procedure during which a small flexible endoscope is introduced through the mouth (or with smaller caliber endoscopes, through the nose) and advanced through the pharynx, esophagus, stomach, and duodenum." Thinking about it it makes sense... most of your stomach is getting stapled off and cut away so they have to make sure that it and your duodenum are healthy because there will be no easy way to see them ever again. Status: see today's frustrations below.
9. Start exercising. I almost forgot about putting this on the list -- Freudian slip? For me this is and probably always will be the hardest thing. Now that I've lost 38 pounds (as of last week) I can walk about 100 steps without wheezing (I was down to about 10). And they want me walking 12,000 a day! OMG!! When Scott and I were in our best condition walking around the lake at the Lab regularly we killed ourselves to get to 10,000 in a day -- and that took months -- and I was a good 50-75 pounds lighter than I am now -- and I didn't have the ridiculous wounds that just won't seem to heal that I have now. Whah whah whah... Thankfully they won't prevent the surgery if you don't get to this before then, but it remains the goal before and then daily after surgery. Status: see today's frustrations below.

Today's frustrations

My longest standing frustration is with my PCP. I am ready to scream!! John and I saw my surgeon for the first pre-op visit last Wednesday morning (9 days ago). Since my surgeon's in Oakland and I hate going to the big city, he provided a couple of letters and a checklist to share with my PCP requesting I obtain referrals to local resources for items 2, 4, 5 and 8 above. I faxed all with a letter from me to my PCP that same morning. I called to confirm it was received and legible. I've been calling every day since for the referrals and am continually told the doctor's busy -- sorry -- the staff's doing all they can. Argh! My PCP's been one of the doctors that's encouraged me to follow this path, and now he's putting up major roadblocks. I have a physical on the books with him for the week after next. I am also seeing my (wonderful) endocrinologist next Tuesday. I am hopeful that he'll help with some of the referrals if I don't have them by then, and if worse comes to worse the PCP will have to help me when I'm in his office face to face in a couple of weeks, but this is ridiculous... and it gets worse.

Bringing me to my newest frustration -- the good news and the bad news. Remember those millions of blood tests I mentioned in 6 above? Well there were also some urine tests. Three docs ordered things -- my PCP, my endo and my surgeon. My endo called this morning (yes, as soon as I heard his voice I was worried, wondering why he was calling me on a holiday at 9 AM). He proceeded to share the great news that my A1C test came back at 6.5 (hip hip hooray -- down from 7.0 last quarter -- and you want this number under 7 if you're a diabetic). And then the reason for the call. My kidney function tests came back not so good. Protein in the urine. High potassium. Uh oh. He's immediately withdrawn two of the meds that I'm on. Directed me to call my PCP and suggested I also call my surgeon and let them know that he's faxing over the lab results he received and wanted my PCP to fax to him the urinalysis results that the PCP should have that he didn't. So at about 9:15 this morning I left a message for my PCP telling him all this and asking him to call me -- and now 8 hours later no call. Argh. I called the surgeon's office and left a message a few minutes later and his RN called back within the hour to have me stop my current pre-op diet. She was great -- very reassuring. Said that since I've never had kidney problems before they should bounce back. And oh by the way if you're taking any diuretics you should ask your PCP if you should stop. So I just left him another message. I am not holding my breath waiting for him to call back...

Final frustration of the day: these ridiculous wounds that refuse to heal! Given how much pain they have me in, it really speaks to my the frustration level I have with my PCP -- that this is subordinate to that on the list. I've been seeing a wound specialist for the last week and a half and his treatment seems to be helping from a visual aspect (or so John tells me -- they're in my groin area so impossible for me to see well) but the pain aspect ain't so great. It hurts to sit forward -- the only chair I'm comfortable in is a recliner in a semi-reclined position. The last 3-4 weeks at work have been miserable. One day I got out of my car in tears -- I couldn't even handle the short drive to work. It seems crazy, doesn't it? If I weren't feeling it I wouldn't believe it either... It hurts to walk too so checklist item 9 above isn't making a lot of positive progress.


Successes of the day

OK, let's end with some good things!!

• They've finally fixed the wheel in "Vampire Wars" on Facebook! :) Who could ask for anything more?!
  
• I've started reading the fifth book in the Black Dagger Brotherhood series and it looks to be another good one (thanks Belinda for turning me on to these -- I hope Puerto Vallarta was grand!).
• John has been enjoying his day puttering around in the cellar rediscovering wine treasures long since forgotten.
  
• The upside of changing my diet is that I had real food for lunch (chicken vegie soup) instead of a protein shake for the first time in around a month.
  
• It's a beautiful day -- didn't get quite as hot as predicted. Great breeze right now -- gotta love living in a canyon.
  
• I started a blog! How wonderfully cathartic it has been to finally share some of this experience.
  

Thanks to my family and friends for your support on this journey. Farewell for now... /gailz