Thursday, October 29, 2009

“Learn everything you can, anytime you can, from anyone you can - there will always come a time when you will be grateful you did.”

-- Sarah Caldwell

Day 37 AS

Some great news from Tuesday's blood work: liver function tests came back normal. Although that's what we expected, it's still a relief. We'll never know why they were high last time, but it does seem a reasonable assumption that the trauma of the surgery was a contributing, if not the only, factor.

Some not so great news from my blood work: my uric acid levels are elevatated (10 vs. normal range top of 7). That means that my foot joint pain is probably not anatomical, but gout flaring up. I guess that's better news than not. My doctor told me this is very common with rapid weight loss, and googling confirmed her statement. I suppose that's one of the reasons my surgeon told me the surgery wouldn't help get rid of my gout -- but she didn't tell me it might make it worse. Oh well... the prednisone should help. I just took my third dose and it doesn't ache as badly, but it certainly still hurts. Next week we'll talk about different treatment if need be. The sad side of this are that I've been taking medication twice a day to keep my uric acid levels lower and I haven't had any wine since May, and it's happening anyway. Kind of a bummer -- pain without any of the pleasure ahead of time to make it worth it.

Lest you think me ungrateful, I am very happy the results aren't reversed. I'll take a normal set of liver function tests any day over lower gout results if I can only have one or the other.

The support group meeting was great this week -- over 40 people there! I had my calendar mixed up, so the plastic surgeons weren't there (they'll be there next time). With that many people there were a lot of interesting discussions. One of the useful tidbits for me was the acknowledgment that my broken thermostat is normal. Even though I've only lost 100 pounds so far, it physically feels more like 200 when it comes to temperature -- I am cold seemingly all the time when I feel good now. The post-op only group theme was "change" with a focus on the psychological changes people may/may not have 2 or more years post-op.

Tuesday, October 27, 2009

"The tragedy in life doesn't lie in not reaching your goal. The tragedy lies in having no goal to reach."

"The tragedy in life doesn't lie in not reaching your goal. The tragedy lies in having no goal to reach." --Benjamin Mays


Day 35 AS

Another exciting milestone on this 5 week anniversary of my weight loss surgery: I have "officially" lost 100 pounds since my high weight in April - roughly 60 pre-op and 40 post-op. Woohoo!

I saw my internist this morning for a follow-up and she seemed very pleased. Even after cutting my blood pressure in medicine in half I'm still running low -- 100/70 today. I have to monitor it twice a day and if it stays here I'll have to cut it in half again... what an amazing thing. Now if only my blood sugar would follow suit -- my endocrinologist and I haven't quite gotten that where it belongs yet. It's lower than it was a couple of weeks ago with the addition of an oral med, but higher than I like it to be. I see him again in two weeks and we'll see what magic he can pull out of his hat then if it's not better. This seems crazy to me as I'm eating so very little, but it is what it is.

My walking's suffered over the last week due to a sore foot joint, so my internist looked at that today. She pondered whether to send me to a foot doctor for a cortisone injection or to try that amazing prednisone for 3 days again and decided to start with the latter. As soon as I eat lunch today day 1 will start. I remember taking this a couple of weeks before surgery and I felt great -- it eliminated all pain in my body for over a week. Hopefully it will do the same again, and by then clear up the inflammation in this joint altogether and I can dodge the cortisone injection bullet -- I hate those!!

The other slightly nagging issue out there was my last set of liver function tests. We're all assuming that it was just a post-op anomaly, but just in case, my internist had me retest that today too. Fingers crossed they come back normal this time...

This is one of those two outing days... late this afternoon is support group. A couple of plastic surgeons are coming to chat with us about that challenge. I'm more than a year away from that, but it doesn't hurt to get the information so I will attend.

My 100 pound "reward" (aside from the health improvements of course) is a Wii system and a Wii-fit plus game. Hopefully this foot will stop being so annoying and I will find the games somewhat motivational. Exercise remains my greatest challenge.

Showering still isn't perfectly normal, but for the second time in a row at least I didn't feel like throwing up after getting out of the shower today -- yay. Still exhausting, but better that than both. As for the nausea I felt every time I brushed my teeth, the good news is that switching back to an old-fashioned manual toothbrush has helped tremendously. Brushing my teeth is a pleasure once again. Ok, that may be an exaggeration of sorts -- at least it's a non-event now and I don't dread doing it.

Ending on a positive note, I had a lovely afternoon Sunday visiting with two of my colleagues. It was great seeing them and catching up on office and personal going-ons. I really appreciate both of them making the time to come over and say hi! I return to work next Thursday -- six weeks after surgery. I'm looking forward to seeing all of the great people I work with -- and hoping by then I won't be so darn tired all the time.

Thursday, October 22, 2009

On having a good right hand...

“I would rather have had one breath of her hair, one kiss from her mouth, one touch of her hand, than eternity without it.” -- Spoken by Nicholas Cage in "City of Angels"

Day 30 AS

I'll start today with the good news that John's hand surgery today went very well. If you ever need a hand surgeon in the Bay Area, he's batting 1000 -- he did a great job on my right hand last year and seemingly a great job on John's right hand today. Plus he's a really cool guy! And John's Mr. Mellow -- even more than usual. Valium is a good drug too it would seem. ;)

Tuesday was my red letter day -- real (albeit soft!) food -- something I could actually chew. What a relief from the prior four weeks of only liquid and pureed food. I can now report that I can eat processed turkey and low-fat jarlsberg swiss cheese and my new digestive system can tolerate both. I'll slowly add more foods like other processed meats, poached chicken and fish, eggs, cheeses, over-cooked vegetables, over-cooked pasta and over-cooked rice during this 4-week stage. The key is for the food to be soft soft soft. I'm still struggling with getting to my daily goal of 75 grams of protein, so hopefully this will help.

Monday, October 19, 2009

On eating and drinking...

Nothing would be more tiresome than eating and drinking if God had not made them a pleasure as well as a necessity. ~Voltaire

Day 27 AS

Not a lot to report. Same old - same old. Overall doing pretty well. Dizziness has thankfully subsided, I'm left with just feeling tired all of the time now. Yesterday was a little weird -- I had a hard time keeping pureed foods down, and was kind of sick getting out of the shower (yuck) but that seems to have thankfully subsided today.

The other weird thing is that I'm still not hungry. I know the head-hunger is going to hit me one of these days, but so far, so good. I am eating 3 times a day because I need to -- not because I want to at this point.

Next big milestone is tomorrow -- I get to start eating "soft" foods for a month. Just like a baby, I'm supposed to add one food at a time to make sure I can tolerate it. If it doesn't work (and I shudder to think what that means!) then I wait a week and try it again. John got me some good supplies to try -- an assortment of "processed" meats (recommended as it will be easier to chew to the required applesauce consistency -- I can also eat poached and boiled meats -- ugh), eggs, and some soft low fat cheeses. Ripe bananas and canned fruit (with any syrup washed off) are also on the list, as are overcooked potatoes, sweet potatoes, white rice and pasta. The hard part is that I also have to start the no beverage with meals for the rest of my life phase or for 30 minutes afterwards. I've always consumed tons of water with my meals so this will definitely take some getting used to. Hopefully with the meals only being 3 ounces (3/8 cup) in total I won't miss the water too much.

The number one priority remains getting all of my protein in. I am still struggling to get to my goal of 75 grams/day.

Thanks to John I have found another pureed food I like: smoothies. Yum! Yesterday he made a banana smoothie for breakfast and added some of Elaine's protein supplement -- it was delicious. We tried kefir for the first time with this and found it pretty tasty -- filled with protein. A few days earlier he made a banana strawberry one that was pretty tasty too. One thing I've noticed is that I still prefer "simple" flavors -- not too much spice or too many complex flavors. That seems to be getting better with time, so hopefully in another week or two that won't be an issue any longer.

Wednesday, October 14, 2009

Get started now.

“Don't wait until everything is just right. It will never be perfect. There will always be challenges, obstacles and less than perfect conditions. So what. Get started now. With each step you take, you will grow stronger and stronger, more and more skilled, more and more self-confident and more and more successful.” -- Mark Victor Hansen

Day 22 AS

I had a good visit with my surgeon this morning -- she is pleased with my progress. She confirmed the 30 pound weight loss over the last 3 weeks and said that it's better than expected -- typically this is more like 10-15 pounds. I asked if this was a concern then, and she said not -- that I'm one of the lucky ones whose body seemingly isn't reacting as though it's being starved as many do during the first month, causing them to hang on to some fat. Interesting.

I shared with her also my concerns regarding continuing exhaustion and occasional dizziness, and she agreed with my internist that cutting the blood pressure medication in half should help, but reminded me I will be tired for a couple more months. I also told her about cutting out the cholesterol med until my diet is normalized and she suggested I contact my internist and add this back -- perhaps at a lower dosage. She noted that during rapid weight loss there are a lot of lipids floating through your blood stream so that it might be a good idea to keep on that for the time being. I called her and she agreed, so half dose it shall be.

I also told her that I still can't sleep in bed because when I roll over onto my left side it feels like my stomach's falling out. She reassured me this was normal, particularly for someone like me that carries most of my weight in my abdomen. When I roll over onto my side it puts a lot of stress on the sutures, giving me the sensation of the stomach falling out. She suggested I either wear the abdominal binder when I try to sleep in bed or continue to enjoy sleeping in the recliner for a few more weeks and just don't worry about it -- I think I'll go for the latter!!

She also cleared me to try to ride my stationary recumbent bike now also, as long as I pay attention to how I feel. She suggested I may not be able to ride for more than a couple of minutes, and if that's the case to stop. It will be nice to add something to walking in my exercise repertoire.

Last night John joined me for the support group. It was a good meeting -- lots of good questions from pre-op patients. There was another 3 week post-op patient there (who'd had the lapband rather than the gastric bypass), so the facilitator let us ask about our biggest current challenges. The other 3 week patient is having a hard time with her fluids (thankfully I am not!) so the group gave her some ideas. I mentioned how much I am hating the pureed food in general and the facilitator (an RD) told me not to worry -- stick with fluids if I must. She went on to say most people eat inappropriate pureed foods anyhow, and that it's such a small quantity of food it doesn't really matter. Seems like an odd response to me... I will continue with my common sense approach I think -- the vegetarian soups with added protein powder. I mentioned this issue to the surgeon today and she said getting my protein is the most important thing -- so if I need to drink more milk, eat more yogurt and scrambled eggs, go for it. Just get to my goal of 75 grams as fast as possible. My last couple of days have been 50 grams, so I have some work to do on this. There are 8 grams of protein in a cup of milk and 6 grams in a quarter cup of scrambled eggs, so they are pretty good sources. It's really strange to think in terms of food's nutritional value, rather than just as something that tastes good...

After the pre-ops were excused, the post-ops had a discussion regarding exercise. I know this is going to be the hardest area for me to conquer during this journey. The good news is that my knees are already feeling better -- I don't wince every time I stand up. We each had to talk about our plan individually. The folks that are a year or more pre-op are all regular gym-goers now -- on average 5 times/week. Our facilitator warned us not to start a program we can't commit to -- because once you stop you will gain weight unless you start eating less. I don't see myself as a gym goer to be honest -- we'll have to see what alternatives I can come up with for me. A couple of people start their days off with hour-long walks with their dogs... I wonder if Ali or Cari would like to walk on leashes? :) Somehow I don't see John ever going along with a dog being added to our household...

I met Fern's friend Janet last night at the support group -- that was fun. She looks great 4 months post-op. She is jogging now for the first time in decades -- very fun. She had a lot of the same challenges in her first six weeks that I am having now, so it was encouraging to see her surviving these and moving on to feel better than she has in years now.

One of the interesting differences between Pleasanton and Oakland has been the difference in sizes of patients. I felt a lot more "at home" in Oakland -- there were a lot of patients my size and larger there... in Pleasanton I wonder how some of these people qualified for the surgery in the first place. There were a couple of pre-ops there that I'll be ecstatic if I look as good as they do today a year from now!

Two outings tomorrow -- I'll have to be sure to nap in-between. I can't believe how tired I am after just one small excursion. Wish me luck!

Tuesday, October 13, 2009

Independence

“Every human has four endowments- self awareness, conscience, independent will and creative imagination. These give us the ultimate human freedom... The power to choose, to respond, to change.” --Stephen R. Covey

Day 21 AS

It is great to be independent again -- I drove yesterday for the first time post-op and again today. Yesterday was to the phlebotomist who got it right the first time (yay) and today to my internist.

Climbed on the scale today and... was totally amazed. Since my high weight in April I'm down 89 pounds now -- depending on what you use as my last pre-op weight, I'm down approximately 30 pounds over the last 3 weeks. It's amazing how much you can lose and how quickly when you don't eat much... which is the point after all. Good to see it's succeeding so far.

My internist is making some med adjustments too -- cutting my blood pressure med in half, stopping cholesterol until I start eating "normally" again and cutting out my asthma med (let's see how I do). She thinks my bp is too low now (I never thought I'd hear those words!) and may be contributing to my constant exhaustion and occasional dizziness. Hopefully this will help both!

Another outing this evening -- post op support group. It will be a change of pace -- I'm used to being kicked out of the last hour (reserved solely for post ops) -- this time I'll be staying. It will be interesting to see if the group shares more gory tales (explaining why the pre-ops are excused) or if the facilitator simply wants to leave some time for this group exclusively.

More "outings" planned later in the week. I see my surgeon again tomorrow. Thursday I have my post-op nutrition class -- maybe they'll have some more ideas how to survive this pureed food stage. I'm finding this difficult -- the vegetarian approach with protein powder has made it bearable, but it is still difficult. I was discussing this with my internist today and she suggested I ask if ground meats without pureeing them are OK... I will check that out Thursday.

I see my wonderful endocrinologist Thursday late afternoon. My internist wants me to schedule him monthly, along with her monthly, staggering them by two weeks so I see one or the other every 2 weeks. Makes sense. She warned me there will be lots of blood work ahead as between the two of them and my anticipated weight changes over the next few months we'll be playing with what meds I can reduce vs. cut out altogether while keeping healthy. It is great having an internist now that really wants to be engaged and help me be the healthiest I can be -- she really feels like a partner.

The weather has been crazy today -- right now a fairly gentle rain, but prior to now it's been a non-stop down pour since the wee small hours -- very unusual for October here.

Thursday, October 8, 2009

Who knows what tomorrow brings?

Who knows what tomorrow brings
In a world where few hearts survive
All I know is the way I feel
When its real I keep it alive
The road is long there are mountains in the way

Love lift us up where we belong
Where the eagles fly on a mountan high
Love lift us up where we belong
Far from the world below
Where the clear winds blow

Some hang on to used to be
Live their life looking behind
All we have is here and now
All our lives out there to find
The road is long and there are mountains in my way
But we climb the stairs everyday

Chorus

Time goes by no time to cry
Just you and I alone

Chorus

Music by Bernard Alfred "Jack" Nitzsche and Buffy Sainte-Marie; Lyrics by Will Jennings

Day 16 AS

What a crappy wife I am, and what a wonderful husband I have!! I have no idea how I got to be so lucky, but I am certainly not going to complain.

Today is our 26th wedding anniversary. I woke up as John came up to start getting ready for work and he presented me with a lovely card full of sparklies (and we all know how I love sparklies!). He made me some lovely tea and proceeded with all of his morning things. Before he left he made me some Pea Soup Andersen' soup and it actually tasted good with no bad side affects -- woohoo. He had been inspired by the baby food aisle when selecting that particular soup. There were 3 stage 1 flavors, applesauce, squash and pea, so he figured if it was good for people when we learn to eat it will be good for us when we have to relearn how to eat -- and he was right!

Shortly before noon the doorbell rang and it was my favorite florist (La Petite Fleur in P'ton). The florist put together a lovely arrangement at John's direction full of red roses and my favorite rubrum (aka star gazer) lilies.

What a crappy wife I am -- I didn't do a darn thing to let John know how much I appreciate him.

I can now add one more thing to the list of foods that don't puree well: hot and sour soup. Ugh. We tried that for dinner last night, and all I could taste was the vinegar. I think I'll end up trying just vegetarian soups and purees for the next week and a half pumped up with some of Elaine's protein powder. For lunch I took some more of that pea soup and did just that -- and it was yummy. I'm about 1/2 way to my daily protein goal. It's so much harder to do that I thought it would be!

Other than that, nothing new -- still periodically a little dizzy and still a lot tired.

Wednesday, October 7, 2009

"Look ahead, not back"

“The young sailor at sea was ordered to climb a mast to adjust a sail during a violent storm. He got halfway up, looked down, got dizzy and sick. An old sailor on deck shouted up to him Look up, son, look up. Young sailor looked up, regained his composure, and completed his mission. Moral: Look ahead, not back.” - Unknown

Day 15 AS

Not a lot of excitement to report... I'm feeling a lot less pain but am exhausted seemingly all the time. So much for my big plan to go back to work after two weeks -- silly me. I spent almost all day Monday sleeping, and while I was awake I was dizzy -- kind of weird.

My big treat is an outing this evening to my hairdresser. I am hoping I'll be able to deal OK with a couple of hours in her chair. I am definitely looking forward to a little pampering. John is going to be my escort so I don't have to drive yet. I was a little dizzy getting out of the shower again this morning so I think this is a very good thing.

John made a couple of pureed soups for me last night. I'm finding my taste buds are hyper-sensitive -- he used just a wee bit of tarragon in the chicken with mushroom soup and it is still very strong to me. The soup's good, but 1/2 cup goes a long way now! The other was also chicken based with mexican flavors -- in this case the diced chiles he used are very strong flavored to me. It seems odd -- I usually love really strong flavors -- I guess I need to start thinking in terms of I used to love really strong flavors...

Sunday, October 4, 2009

"A true friend is someone who thinks that you are a good egg even though he knows that you are slightly cracked"

"A true friend is someone who thinks that you are a good egg even though he knows that you are slightly cracked" -- Bernard Meltzer

Day 12 AS

Another fun day, this time thanks to Elaine and Steve who stopped by for a lovely visit with John and I, bringing some lovely fall flowers (in a purple vase no less!!) and protein powder... bless you! :)

That is my next big challenge -- getting up to those 75 grams of protein per day -- I am up to about 14 or 15 now -- it seems like an endless way to go at the moment.

I am continuing to feel a lot better, but did have an uncomfortable dizzy spell after showering this morning. I checked my blood sugar and that was not the problem. Elaine asked me when the last time was that I had consumed any calories and that may well have been the issue. I will try eating something before my next shower to see if that helps. John also asked if I bent my head a lot and I did -- so caution there too I guess.

We had the best dinner last night in remembrance of my beloved God-daughter Allison. She loved Mexican food, so on her birthday every year we consume it in her memory. I was not quite sure how I was going to do that this year, (which would have been her 22nd birthday), until I hit on the idea of getting some good Mexican soup and enjoying the broth. John picked up some lovely Caldo de Pollo from Casa Orozco, portioned out some broth for me and ate the rest himself along with a beef quesadilla -- we were both very happy. I know Binky would be happy to know that thanks to her I had the best meal yet, post surgery. It is great to enjoy food flavors again. I confess to being a little worried about that last week.

This coming Tuesday (in 2 days) marks my graduation to pureed foods -- oh boy. I am almost looking forward to that. Fingers crossed!!

Thanks again to all who have called, stopped by, send emails, cards and other lovely treats. One of my favorite cards has been from Tricia and David featuring "Dr. Dreamy" who was sporting a great big GE surrounded by a heart on his white coat -- loved it! :)

Nap time (again!) now...

PS: A special congrats to the great PMs on the To9! program -- I knew you guys would bring this home today... awesome job!!! Thanks for keeping me in the loop!! I am very proud of you -- you have achieved the seemingly impossible.

Friday, October 2, 2009

“There is a harmony in autumn, and a luster in its sky, which through the summer is not heard or seen, as if it could not be, as if it had not been!”

“There is a harmony in autumn, and a luster in its sky, which through the summer is not heard or seen, as if it could not be, as if it had not been!” -- Percy Bysshe Shelley


Day 10 AS


Well, I still have quite a way to go but each day I continue to feel a little better. Today's been my first "fun" day -- John and I both needed to have some blood work done so we had a mini outing this morning to the phlebotomist. Can't say that part was fun (although thankfully I had a great phlebotomist who got me the first time -- yay -- clearly the blood thinners are still doing their thing I might add, given how well I bled after the fact...). But seeing the beautiful autumn morning light was quite grand. I love the light this time of year.

I had my first official visitors this afternoon too and somehow fittingly that was Fern and Roger. They've been great friends forever and I truly appreciate both of them. Leave it to Fern to come up with perfect gifts too (although not expected, they were quite lovely!) -- a fun book on cats that rule the world, an outdoor magazine featuring 100+ techniques for good outdoor photography (a dream of mine to return to) and the current issue of Vogue, so I can start thinking about what kind of clothes I want to buy again one of these days. How very thoughtful!

Fluid consumption is something I look forward to rather than a duty now -- yay. I've found some other things that are tasting good too -- strained "healthy choice" cream of chicken soup, watered-down protein beverages, lime jello and any sugar free popsicle. There's hope!! It's going to take me forever to get to my 75 grams of protein goal (I'm at about 6 now), but there's hope now!! My digestive track is definitely waking up finally -- have I mentioned lately how incredibly wonderful a great fart can be? :) I will never underestimate them again!!

I am trying a day without the anti-nausea medicine today as it makes me dizzy and I won't be able to drive until I'm off it. So far, so good, so fingers crossed... if I can wean off I can drive again in a week. This will coincide with the addition of pureed foods to my diet -- woohoo...

John found out last week that he has to have hand surgery now. Sigh. Thankfully I know he's in good hands (every pun intended) as he is seeing the great hand surgeon that performed my carpal tunnel release early last year. Different issue though -- he had a big knot at the base of his right hand middle finger causing incredibly painful trigger finger. When he wakes up it's totally locked and he goes through awful pain to release it. He will likely have that taken care of in a couple of weeks.