She handed me a gown, a garment bag and some wipes and directed me to the bathroom to change. I was instructed to take off all my clothing, jewelry, hair pins, etc., wipe my abdomen thoroughly with the wipes, and the put the gown on, open to the back. After I finished changing I went into the prep room where the nurse took my weight. According to that scale I was 297.7. That scale is a little off from my scale at home which told me I was 303 that morning, but I definitely like the Dr.’s scale better. If that’s compatible with the scale at the gym, it means I lost 15.7# on the pre-op diet alone. Although I have a feeling that my bathroom scale is more compatible to the gym scale, that would still mean I lost 10.4# in a week. Pretty nice, huh? Anyhow, the nurse proceeded to ask me a ton of health history questions that I’d already answered twelve hundred times in the last week. Next she hooked me up to an IV in my left hand with lactated ringers solution and an IV antibiotic drip of Cefazolin. I was given an injection of Lovenox in my stomach to prevent clot formation. Around this time Dr. G popped his head in to say hi. Once I was done getting prepped, my parents were brought in to sit with me while I waited for my surgery. The anesthesiologist popped by as well and asked me a bunch of the same questions about my history again.
Finally just before 3PM, it was time. I was given an injection of some “happy juice” to relax me. I forget the exact name of the medication, but it’s in the valium family. I was told that after the injection I might not remember anything, but this didn’t turn out to be the case. I remember being rolled into the OR. Some good song was playing, though I can’t remember which one and I started singing along as I sometimes have a tendency to do. I remember the nurse joking with me asking how I knew it was karaoke day at the hospital. I was moved from the gurney to the operating table and strapped on. It was, of course, as soon as my arms were strapped down that I got an itch on my nose. The nurse kindly scratched it for me before placing the mask over my face and telling me to take deep breaths.
I could hear stuff around me and I was crying. I heard someone jokingly tell me I was making them sad, but I couldn’t stop. I could feel myself being wheeled out of the room towards recovery and I tried to open my eyes and focus on what was going on around me. I knew where I was and what was happening and I wasn’t sad or frightened and while it hurt, the pain was hardly unbearable, but still I wouldn’t stop crying. After a little while my eyes were able to focus better and my tears calmed down. I could see the clock across from me and it was 4:30 pm. My mouth was completely parched and the pain was definitely there. The guy who was with me in the recovery room asked me to rate my pain on a scale of 1-10. I told him I was a 6, and he gave me a nice shot of some happy, happy pain meds into my catheter. This brought me down to a 4 so he gave me one more shot and got me down to about a 2, which was nice. He also gave me some ice chips which were just about the best thing in the world by that time.
At this point I was awake enough and they brought my parents in to see me. We talked for a little while and I realized I felt like I had to go to the bathroom. It wasn’t until I voiced this concern out loud that I found out I had a Foley catheter in, so apparently I didn’t have to go after all. After a little time spent with my parents, my sister and grandparents showed up. My sister brought me a nice care package with a couple of magazines and some beauty products—and best of all a pin wheel. I haven’t had a pin wheel since I was like, 11. It was purple and silver and not only was it fun to blow on, but it helped me take deep breaths which was good for me.
At around 6:30 the pulmonologist showed up to check me out (Dr. G had been by sometime earlier, though I can’t remember when so it must have been shortly after surgery when I was still all doozey-bots) My family left and the pulmonologist checked me out. He told me that someone would be by later in the evening to set up my CPAP for me, but I didn’t have to use it if I didn’t want to. Instead they could give me a nasal cannula with oxygen as long as I didn’t have any problems over night. He also showed me how to use a device called an incentive spirometer to help me take good deep breaths. I was actually feeling pretty good although the pain was starting to come back so I got a shot of Demerol in my arm.
Once the doctor was gone I got up and walked a few laps around the unit. I passed by the rooms of some of the other patients and I have to say, I was definitely recovering much better than any of the others. One of the other patients was a girl a little younger than me and she asked me what my trick was for recovering so well. I’m not sure I had one but I think maybe the fact that I worked out regularly before this helped me have more energy, plus the extra muscle mass I had because of it probably helped me metabolize the anesthesia better. After about 5 laps around the wing I sat down in a chair in my room for a little while and tried to read the Self magazine my sister gave me. Just before 8PM I took a couple more laps around the ward then settled into bed to watch House and One Tree Hill. After that I dozed for a while and at around midnight they came to take out my Foley catheter and I was able to put on some real pajamas. They had me walk some more and then I got to go to sleep.
In the morning they came down and took us one by one to radiology for our post-op video esophagrams. I had to drink a couple of sips of barium which shows up bright white on an x-ray. They used fluoroscopy (a real time video x-ray) to watch the barium go down my esophagus into my new stomach pouch and then through the band into the rest of my stomach. The point of this was to check the placement of the band and to make sure it wasn’t too tight. As it turns out Dr. G. does put a little bit of saline in the bands to begin with, but if the esophagram showed it was too tight they would have had to take some out.
Everything must have been good with my esophagram because I got a few more meds and a platter of water and fruit ice once I got back to my room. The dietician came by and gave me a brief review of the post-op diet plan I’m going to have to follow and instructed me on how slow I was supposed to eat and drink. The fruit ice went down without a problem and I was discharged around 11AM.
And now I’m back home and sharing the experience with you guys. I feel alright so far. My belly definitely hurts, especially in the area where the port is. Dr. G placed my port on the left just below my rib cage. I have a few pictures up of my battle scars, and I labeled one of them so you could see where all the incisions were and where the port lies.
And that’s about it. It’s done now. There’s no turning back, only moving forward. Today’s the first day of the rest of my life and I plan on making the most out of it.
And what’s worse is that after midnight I can’t have anything at all—not even water. This wouldn’t be so bad if I had to be at the hospital at 7am, but noooooooo. Of course since I’m young and relatively healthy, I get the last surgery of the day which means I don’t even have to be at the hospital until 2pm. On the bright side, that means less time overall in the hospital. I’ll be drowsy for the rest of the day after I wake up and then go to sleep, and before I know it, it will hopefully be morning and I can do my post surgical tests and go home. And even better is that I will likely be in the hospital for less than 24 hours which saves me $225 in copay. But that also means that I won’t stop starving anytime soon.
I suppose I shouldn’t focus on that. I have to focus on the positive—remember what I’m doing this for. I’m doing it to take control of my life. And until today it hasn’t been too bad. The worst part of the liquid diet leading up to today was the lack of variety. Everything tasted sweet except the soups. I have a major sweet tooth and all, but this was a bit much, even for me. As the days went by I actually wound up eating less and less. I think day 4 was the hardest; I was still hungry, but didn’t want to eat any more of the foods I was allowed, which meant I didn’t eat as much as I needed and felt crappy. By days 5 and 6 I really didn’t feel much hunger and wasn’t even consuming a full 6 meals anymore, but I still felt good. Of course I was still consuming some meals, which is more than I can say for my broth sipping, ice-pop sucking day today. Man, I’m really starving. Where was I again? Oh yeah, it’s not so bad…
Anyhow, it’s almost over. Or perhaps I should say it’s almost starting. That’s what the lap-band really is—a start. But what I meant was the nerve racking, surgery part is almost over. I’ve kept my nerves pretty well in check, actually. I mean, this is a small hospital with a big bariatric department. They do this all the time so I’m fairly confident that I’ll wake up from anesthesia plus one lap band and not minus one leg or with a bald head and my cranium held together by circlage wire or something. And the anesthesia’s not too scary to me either. I don’t know if that’s because in my job we do anesthesia and surgery every day with 1/10th the resources and the patients do just fine so I’m not that nervous, or because I just don’t let myself experience the nerves because I don’t like to deal with my feelings.
I would however love to deal with the feelings of hunger I’m currently experiencing. Gah, I need to stop thinking about food. What wouldn’t I do for some of that pot roast my mother made for her and my Dad last night? Especially with a nice buttered piece of challah. God, that sounds good. But I won’t be eating that anytime soon. Hopefully one day I will once again be able to enjoy such a treat—in my new lap-band aided policy of moderation, of course. That’s about it for tonight. I’ll be back on Tuesday with the skinny from the big day. Toodles.
Weight- 308.4# (I was actually 313.4# on Mon night so I’ve already lost 5#. Yay me!)
So, there it is, ladies and gentlemen. The numbers don’t lie, but they will change. My next official weight will be on surgery day, then I figure I’ll generally weigh in weekly and take my measurements once a month. Till then, wish me yummy sugar-free jello.
For this week the composition of the food is the most important thing and after surgery the consistency is the most important characteristic. The main component of both diets is the liquid meal replacement drinks. The nutritionist who works with Dr. G recommended the Medifast drinks you order online although she did give me a few alternatives such as Muscle Milk Light and Designer Whey Protein drinks. The drinks are kind of ridiculously expensive but I figured since I wasn’t eating anything else and these three weeks surrounding surgery are the most important, I went with the nutritionist’s first recommendation and ordered the Medifast. It’s interesting that chocolate protein shakes don’t taste like any other form of chocolate known to man. Not that my Medifast drinks are completely awful but they’re certainly not chocolatey goodness either. The ready to drink versions are the best tasting. They come in chocolate and vanilla but I only ordered the chocolate. They also make powdered forms that come in other flavors—strawberry crème, orange crème, and swiss mocha. I’d have to say the swiss mocha was the best of the powdered drinks but the ready to drink ones are the best overall.
I’m also allowed to have soup. Right now I can eat soups without removing the chunks, although they must be less than 3 grams of fat per serving. After surgery the fat content doesn’t matter so much, but I can’t have any chunks. This is because there will be swelling around the band and solid food will not be able to pass from the stomach pouch they create into the rest of the digestive track. I can still have chicken noodle soup if I want, but only if I puree it, which sounds honestly disgusting. Otherwise I can drink smooth soups like cream of tomato.
The other food items I’m allowed to eat are fat free, no sugar added yogurt (though it can have natural sugar from the dairy and from fruit), fat free, no sugar added pudding, skim milk, sugar free Jello, and no sugar added ice-pops. During the first three days of the pre-op diet the nutritionist said I could have saltines, plain vegetables or 1 piece of fresh fruit, but recommended keeping those items to a minimum.
Sounds appetizing, right ;) But so far it hasn’t been so bad. I’ve been told the first three days are the hardest and I’m halfway through day 3 now. If this is the hardest, I’m sure I’ll be able to make it through. Am I hungry? Of course. Was I craving a piece of the cheese cake or the homemade perogies the people in my office brought in on liquid diet day # 1 (wasn’t that so nice of them?)? Hell yeah! But I haven’t had any head aches or dizziness and I’m not ravenous or anything. I’ve been going to the gym everyday and I don’t have as much energy to push myself hard, but I’m still making it through. And honestly, knowing I can’t have something makes it easier for me. Usually I have an internal debate with myself about whether or not I should eat something. But now when I want it, I know I can’t have it and that’s all there is too it. There’s no debating about it and that means I don’t focus on it as much.
Of course I’m still worried about how well I’ll do after the surgery when I’m allowed to eat regular food again. Will I still have so much self control once I have my options back? I hope so, but I guess only time will tell.
Five days to Band-land.
Tomorrow I start my pre-op diet. I did try to be good this past week, at least in the beginning. But then I seemed honestly, legitimately more hungry than usual and my junk food cravings were unbearable. I would be good all day then come home and give in to the ice cream in the refrigerator or feel the intense need to stop at 7-11 on the way home and pick up a candy bar (or two). This definitely didn’t help my nerves. If I can’t even go two days without chocolate, how the heck am I supposed to go two months without solid food? What if I really can’t do this? What if I fail?
Sure, I’d considered the possibility of failure going into this. I know the statistics. I know it doesn’t work for everyone. I know a lot of people find ways to eat around the band and manage to eventually gain back any weight they lost in the beginning stages. I knew that I might never reach my goal or that I might, in the long run, not lose any significant amount of weight at all. I knew these things from the beginning, but all those images of skinny me at my sister’s wedding this fall, or my ten year high school reunion next year, or me in a sexy outfit in a bar in the city getting hit on by cute boys sometime in the foreseeable future, were the possibilities my head focused in on. I figured once the changes had been made to my body from this surgery I wouldn’t be allowed to pig out. I wouldn’t be able to binge on junk food. And I’m a good girl; when there’s a rule I follow it. So long as I had a hard and fast reason to eat better, I would stop being able to rationalize the bad things I ate, and I would succeed. Or at least that’s what I believed—or what I wanted to believe.
But I know it’s not going to be that easy. I’m going to be fighting those cravings all the time, especially in the beginning and If I couldn’t say ‘no’ this week, how will I do it next week, and the week after that, and for the rest of my life? Will I find a way? Or will this just be another failed attempt of mine to lose weight?
And that’s not all that scares me. Because let’s be honest here—I didn’t get to be 315 lbs by not liking food. In fact, I love food. And I don’t just love food. I love sitting down and stuffing my face with mass quantities of disgusting, bad for me food.
Right now I’m living at my parents house, since I had no money when I graduated vet school, and decided to stay at home for a year or so and save up money to buy my own place (which I will be moving into in a couple of months, but that’s a blog for another day.) Anyhow, the point is that even though I’m living at home, I’m 27, an adult and a doctor who is responsible for many lives on a daily basis. I should be adult enough to be responsible for my own life. My choices should be my own and I shouldn’t have to hide things from my parents just because I’m living under their roof at the moment. And yet, I do. I don’t hide boys, or pot, or alcohol--I hide food. When they go away and I know I’m going to have the house to myself, I think—“oh yay! I can stay in and watch a movie and order an entire pizza and eat it by myself.” I know this is not a healthy view to have on food, or on life in general, but it’s the way my mind thinks. I actually look forward to the opportunity to binge.
And now I won’t be able to do that again—ever. Which is good. I shouldn’t ever do that. But that doesn’t mean I don’t want to. And knowing that I can’t use large quantities of food to comfort myself is scary. Now I might actually have to deal with my emotions and to be perfectly honest, I don’t even think I know what my emotions are any more, I’ve been eating them down for so long.
And then there are the minor scary things. I’ve never had anesthesia before or even spent a night in the hospital (except the sleep studies I had to do) both of which I will have to do next week for the surgery. How will the recovery go? Will I be in much pain? How will I survive a week at home with my mother without the possibility of escaping to work? (that last one is definitely the scariest.)
So well, the freak-out isn’t exactly over, but I guess I’m done ranting about it for now. I’ll probably be back a few more times this week as D-day approaches. Tomorrow I think I’m getting weighed and measured by my PT at the gym so I’ll have some accurate starting stats to share with you. Until then, I’m going to try and convince myself that a week of Medi-Fast and fat-free, no sugar added yogurt sounds delicious.
So I know I kind of disappeared off the face of the blog-o-sphere, and so shortly after I appeared, but fear not, I have returned. (Was that a run on sentence? I think it was but I have always sucked at grammar. Please forgive me my faults. :P) Anyhoo, I apologize for my prolonged absence. I tried to sit down and write a couple of times, but I was sick, first with the cold from hell and then with a stomach flu and I was busy with all my pre-surgical testing during all of it. By the time things settled down this blog had kind of fallen by the wayside. But now I’ve finished all of my pre-op requirements, been approved by my insurance company and set a date for surgery and my excitement towards telling my story has been renewed, so here I am.
In three weeks, on April 27th, 2009, I will enter bandland. I can’t even begin to imagine the ways my life will change during the course of this journey—oh who the hell am I kidding? Of course I can imagine it. I’ve been imagining it for months. I’m sure the truth will be nothing like the fantasies—good and bad ones alike—but yet I continue to imagine. Will I reach my goals? Will I surpass them? Will I fall short? Will I lose a ton of weight only to gain it all back like every other time I’ve tried to lose weight? Will I need more surgery after I’ve lost the weight to remove excess skin? How will I look when I weight 200lbs? 175? 150? How will I feel? Damn, there are so many questions. I guess I’ll get the answers eventually.
The next three weeks will be spent preparing physically and mentally for the major step I’m about to take. I think the first two weeks will be mostly mental. I haven’t really made any changes to my eating habits yet. I want to start developing some habits—eating slow, chewing thoroughly, figuring out what “comfortably full” feels like, and what might very well be the hardest change of all—weaning myself off of diet coke. There are no dietary rules yet but I certainly hope to be able to make changes even in the absence of rules. This is my life and my body and I need to start taking charge.
I also need to start using a CPAP machine. CPAP stands for continuous positive airway pressure. I had to undergo a sleep study for pulmonary clearance and I was diagnosed with obstructive sleep apnea; a condition where I stop breathing in my sleep. This causes me to wake up—although I don’t realize it—and prevents me from getting a good nights sleep. The CPAP machine is worn when I sleep to keep me breathing. I was told that I was required to have the machine and bring it with me to the hospital on the day of my operation. At first I had no intention of wearing it; it’s uncomfortable, and claustrophobic, and well, honestly, pretty embarrassing even though I have no one to see me in it. But, after reading some stories of others lap-banders with sleep apnea, I decided to give it a try. We’ll see how well that goes.
Then, the week immediately prior to surgery I have a special diet to follow. It’s a modified liquid diet to prepare my body for surgery. One of the main purposes of this diet it to shrink my liver so that Dr. G. will be better able to visualize my stomach laproscopically during the procedure. The week before surgery I will also need to head to the hospital to undergo some pre-op tests and meet with the nurse. Then I will have to go to my PCP for a physical and final medical clearance for surgery.
Three weeks seems so far away and yet so frighteningly close. This is going to change my whole life. I know I’m ready for the change, but it doesn’t make it any less scary. Still, I’m not second guessing myself. It took me a long time to make the decision to do this and I’m positive I’ve made the right one. Twenty-one days and counting down.
(Originally posted 1/4/09)
I have always been overweight. In elementary school there used to be a day every year where they weighed you in gym; I think it was at the same time that they did the scoliosis test. I don’t ever remember a year where I wasn’t afraid and embarrassed to step on that scale. My parents tried to get me involved in sports to help control my weight and I played little league soft-ball and soccer, but it didn’t keep the pounds off.
By the time I was 12 and heading off to junior high, my parents were even more concerned about my weight and the implications it would have on my social life. That summer they shipped me off to fat-camp. I lost about 25lbs that summer and gained about 50 the following year. During junior high I joined the cross country and track teams and ran for miles (albeit very slowly). But no matter how many pounds I ran off, I ate more on. I tried plenty of diets: Weight Watchers, Atkins, I met with nutritionists, I even gave bulimia a stab. I went to a psychiatrist to help me deal with my issues with food and managed to get my binging and purging habits under control, but the obsessive over-eating continued to plague me.
When I went away to college my daily exercise decreased and my eating—with all you can eat cafeterias, and no parents on my case—increased. I gained even more. The first time I remember weight-loss surgery coming up was my senior year. My parents wanted me to do it but I wasn’t ready—It scared the bejesus out of me. One night, after discussing it with my parents on the phone, I decided I needed something drastic. I headed off to Walmart to buy some of those stupid, dangerous, Ephedra, over the counter weight-loss pills. I was depressed and desperate for something to help me. I needed these to work. I never even really got to give them a chance. Just buying them gave me a panic attack. It was probably the scariest experience of my life. It was about as close to an out-of-body experience as I can imagine getting. I felt very far away from all of my surroundings. My heart was pounding and my breathing was sharp and shallow. My head was racing, but it was the same thought over and over again—I had to move. I paced the store, my hands shaking. Stupidly enough I got behind the wheel of my car, but managed to make it home safely. The panic attack was still going strong. By that point it was about 11PM on a Friday night. I felt like I had to do something, I had to keep moving. I rolled up my pants, filled the bathtub with water and bleach, and got in and started scrubbing madly. When I was finished with the bathroom I went into my room, pulled out the top drawer of my desk and began frantically throwing the papers around in what was supposed to be an attempt to organize. Half-way through I suddenly stopped, lay down on the floor where I was and cried. I had a few more miny-attacks as I tried to deal with my depression, but slowly with time, some happy pills from my doctor, and the help of my family and friends, I pulled myself out of that big, black hole. And, of course, I got rid of the Trim-Spa, or whatever it was I had bought that night.
Still, I had no control over my weight. The little exercise I got in college slowed even more in vet school. For a short-while I would walk this huge hill a couple of times a week—about two-miles round trip, but that didn’t last long, especially as my work-load increased and my free-time decreased. I was working 70-80 hour weeks and studying any other time that wasn’t spent sleeping. I certainly wasn’t taking the time out to cook healthy, gourmet, meals—I was stuffing myself full of crap. By the time I graduated I had hit the mark I had always promised myself I would never hit—The big 3-0-0.
It was around this time that I started seriously considering weight-loss surgery. I had always been invested in my education. I put the rest of my life on hold. Now there was no more school and I was ready for my life to begin. But what kind of life could I have trapped in the body of a morbidly obese person? I moved back to Long Island where I grew up, but I didn’t really know anyone in the area anymore except for my family. I didn’t have the built in social circle of fellow class mates that I’d always had in the past and I was (and still am) too insecure to really put myself out there and meet new people. So for the past year my social life has been even more stagnant than before. I’ve got my job of course, which—though I’m still getting comfortable with the new responsibility—I thoroughly enjoy. But when I see an obese cat or dog, I feel like a hypocrite. When people ask me about making their pet lose weight, I usually tell them the same thing…”If I had someone with my best interests at heart controlling everything that went into my mouth, I’d be a lot better off for it.” And it’s true—but why shouldn’t I be that person with my best interests at heart? Despite all of my medical, health, and nutritional knowledge, I’m still slowly eating myself to death.
So, the time has finally come. I know that even surgery isn’t some “magic bullet.” I will have to work hard and make some serious changes in my life. There is a possibility that I might fail, even at this. But I’m ready to take that chance. I’m ready to make those changes. After all, I spent the last 26 years in school learning, preparing, waiting for my life to begin and now that school is over, I feel like I’m still waiting. If I wait much longer for my life to start, I just might be waiting until my life is over.
Well, here goes nothing. I’m about to embark on a life changing journey and I’m here to give you the skinny on getting skinny. Not that “skinny” is really what it’s all about; it’s far too superficial of a word to encompass everything that I’m trying to achieve by undergoing weight-loss surgery. In fact, I don’t even really expect to get skinny at all. Mostly I’m shooting for a healthy, comfortable weight—basically, not fat.
Of course, I’m not going to deny the superficial aspects of my decision. I’m nearly 27 years old and I tip the scales at over 300 lbs. I have no clue what it’s like to feel beautiful, sexy…skinny. I can look in a mirror and like what I see when I’m having a good hair day and my makeup is freshly applied, but that’s only above the neck—actually that’s only above the extra chins. I never leave the house feeling like I’m going to turn heads—at least not for a good reason. I remember being out at a bar a few months ago and some guy offered to buy me a drink. I was confused and politely declined. It was only after a few minutes that I realized that he might be hitting on me. Sure, it’s nice to have other people find me attractive, but what difference does it really make if I don’t find me attractive? If I’m not happy with who I am how will I ever be happy? But I digress from the philosophical, self-help, mumbo-jumbo.
The point is, my motivations go beyond what I look like. My weight problem affects every aspect of my life, in ways most people don’t even think about. Take clothing for example—sure, I can find regular clothes in plus-sized clothing stores, but what about more specific clothing needs? I love to ski but I can’t find appropriate ski clothing in my size. I have to scour racks at the uniform store to find lab coats and scrubs big enough for me to wear to work. I can’t even wear most boots because they won’t zipper up over my calves. There are other things too. Like the last time I flew I needed a seat belt extension. Or the last time I went to an amusement park and I had to sit in a special seat on the roller coaster for people with “large chest dimensions.” There are more common examples like sitting in seats with arms that dig into my sides or trying to maneuver my way through a crowded room and having trouble finding openings big enough for me to squeeze through.
And of course there’s my health which—knock on wood—has actually been quite good so far. I have irregular periods and sometimes I have some lower back pain but otherwise I’ve been lucky up until now. But I don’t feel like waiting for diabetes or hypertension or heart disease to hit before deciding something needs to be done. Yes, an ounce of prevention really is better than a pound of cure.
So basically, if I lose the weight and become a knock-out I’ll be ecstatic. But if I don’t suddenly become a heart breaker, at least I’ll know that my heart is still functioning properly. If I don’t have guys falling at my feet, at least I won’t have lost either of said feet to diabetes. And if my life doesn’t turn out like some of the fantasies in my head, at least I’ll still have a life—and it’ll be one I can live to the fullest.