Sunday, August 31, 2008

Day FOUR

Another good day! I am having trouble getting enough protein. The dietition sheet states about 45 grams a day. Today I took in 23. I think I will try to call Georgia on Tuesday and ask about that.
I remembered something that I didn't write about my hospital stay. I had to stay in the hospital overnight and the next morning they took me to the Xray department to have a graffin swallow test to make certain the band was positioned properly and that fluids could pass through. It was interesting to see the picture as explained by the doctor.
I biked twice today as the rec was closed due to the holiday. I biked for 15 minutes both times and hit 2.6 miles each time. It doesn't bother my knees to bike and I have been working on this most of the past two months.
I tried some South Beach On the Go powder in water tonight. One pack has three grams of protein. I don't know if it was the temperature or the strawberry/banana flavor that didn't seem to sit well. They advise that if something isn't easily tolerated, wait two or three weeks and try it again. I guess I will have to do that.
I wanted to get on the scale this morning but I am afraid of what I see. I have decided to just be patient and weight once a week. That way I won't be disappointed if I don't lose the expected one to two pounds a week.

Saturday, August 30, 2008

Day THREE

Following the orders from the dietician,today was the first day of two weeks of liquid diet. That means I could start to have cream soups, V8 juice, yogurt, milk. I have had a great day and have been quite productive watching carefully not to lift over ten pounds. I marked a bundle of clothes that are already too large for a city wide secondhand sale next weekend. This evening we went to visit our close friends, and the mom just happens to be my Nurse Practitioner, since I was feeling so good. They were canning beans and I must say they looked like candy in the jars. When I got on the scale this morning, it said 230. I broke into tears just thinking about this loss. When I at the hospital, the Case Manager had given me some materials from the maker of my lapband, Inamed Health, and so I filled it out and they will send me a pedometer. I also walked a whole mile today in one setting and felt good doing it. I am so glad I had started to exercise before this event. Tonight when we were driving home, Vince and I began talking about diet. Vince is a most healthy eater and he told about a time in his life when he got severe stomach cramps just eating rice. He told me about finding a book written by Luigi Cornaro, The First Discourse:On a Temperate and Healthful Life. Interestingly Luigi lived to the age of 102 in Renaissance Italy. I think there is much to behold in his two cardinal rules: 1) Eat what agrees with your digestion (quality); 2) Eat as little as possible (quantity).

Friday, August 29, 2008

Day TWO

Well I have been home for about 24 hours. No one tells you the bad parts. And I will try not to dwell on those but it is not a PICNIC! I checked in on time and nurse Kate took my vitals. The most vital to me was the scale. 234.8 Since you might not be keeping track, that is 8.8 pounds from August 6 which is the date when I really started modifying my diet to prepare for surgery. That paid off because CNP Tracy Sorenson said my liver was very small, easy to move, and see around. I didn't, don't have any pain except from gas. I was very bloated in the hospital and no amount of walking did the trick. The pain elevated my blood pressure and Vince was a bit jittery.
Once again Sanford provide an excellent nursing team from RNs to students serving as aides (they have a different title but I didn't get it). I had Sarah and Sophia, Amanda and Deb, and Rachel and Amy taking care of my needs. Alexis was my case manager. Of course, Georgia came by to give me some diet updates and provide her encouraging smile. The surgical procedure took one hour and 30 minutes. I have five incisions on my tummy. One of them is quite badly bruised because that is where the band was inserted. CNP Sorenson explained that she had to inject that area with numbing medication so that I would not hurt so bad after surgery and that caused the bruising. That incision is about two inches wide. The port incision is also in the center of my stomach area and is two inches wide. The other three incisions are only about one inch.
When I arrived back in the room, Vince was there to greet me. He had a gentle smile on his face and I knew it must have gone well. I was tired, a bit scared about what comes next, and somewhat relieved it was over. I had an oxygen nose gadget, I had a blood pressure monitor, and the IV feeding me liquids. I don't remember too much about things other than I didn't have to take that wicked H Pilori medication. All of the medications were given intraveneously except for an injection of heprin that was given right into the stomach to guard against clotting.
I tried to walk often because I knew I would be fighting the gases. I walked three times on the surgery day and four times on the next day. My shoulder had the gas pain from the carbon dioxide they inject during the operation to open the cavity so they can see better. They brought in a heating pad machine similar to the one I used for my rotator cuff surgery (only that one pumped ice water while this one pumped warm water). That seemed to help as I only remember that pain for about six hours. When I finally had the full intestinal gas attack yesterday afternoon, they started a medication or two that restarted the peristalsis of the intestines. I had pretty immediate relief. Vince also monitored the breathing aparatus (this plastic contraption that you take a breath slowly in to ward off pneumonia). He put it in my face every six minutes because the respiratory tech told him ten times an hour. Vince wasn't paid any extra for this care but it goes to show you what a great guy he is. He also took off and put on the leggings that massage your legs to prevent blood clots when I had to get up.
I seemed to feel really good for awhile and then really bad for awhile. That is when the famous expression they tell you about came up. "What have I done to myself?"
I also had a visit from the exercise specialist. I am so glad I had already started this routine as much of what she told me, I knew Thomas was ready to commence. We left the hospital at 4:30pm and I don't think I slept all the way home as I so often have done. I would have to ask Vince.
I slept pretty well in about three hours phases through the night. I would wake up and have to go to the bathroom. I had a little difficulty going back to sleep but would again wake up and find three hours had elapsed. Today I am still on clear liquids. The warm chicken broth really hit the spot. I went to the rec at 11:00 to meet my appointment with Thomas. He weighed me on his scales and I weighed 235 and this scale also gives you a body fat % and the reading was 71. Thomas said that was erroneously high because I still have a lot of bloating. I walked for 15 minutes on the treadmill and accomplished .57 miles. Thomas made me stop because my pulse was up to 143 and that is about my max. Vince and I went back to rec at 2:00pm and I walked again. This time I walked .43 miles so that is my first mile!
Remember my purpose for writing this is to get it all out and if I can help someone else, I want to do that. I so appreciate all my well-wishers. The encouragement really helps.

Tuesday, August 26, 2008

My Guy

Once in every lifetime, each person needs a very special someone to share the moments of life with them. I have that person! Vince is my cheerleader and he so believes in me. I am so very fortunate to have his love and understanding. From the day I met him, I could sense his gentle manner and sincere caring. He has done the research, filed the insurance papers, picked up the medicine, and now kindly encourages me as I step into this new life. Vince is so positive about this decision that whenever I falter and question my abilities to succeed he is there to give me the encouragement I need. Someday, maybe within the year, I will be able to walk comfortably with him around whatever American sites he should choose to visit. I do believe in the expression, "grow old along with me, the best is yet to be".

Monday, August 25, 2008

Pedicure and Diet Coke

With less than 36 hours until the surgery, I have to reflect on this day. Rather than vanity, I would like to consider it "taking care of myself". I had scheduled a pedicure so that my feet would be soft and my toes would be pretty when they wheel me into that surgery suite. I decided that rather than a glass of wine, I would indulge in my LAST diet coke. Call me fickle, I drank it slowly and quite honestly, it didn't taste that great. Vince will be relieved to read this!Considering I have been drinking my calories the last few days, water and tomato juice have become quite appealing. I still have to ingest that nasty liquid antibiotic. Trust me, I have a new appreciation for children who don't want to swallow this stuff. It is horrid! I stopped by the pharmacy tonight to pick up my magnesium citrate (pre-surgery cocktail) and chided the pharmacist about the taste of my prescription. She offered to put in a flavor but when she checked her books, she couldn't do that to a generic. Sooooo, gives new meaning to "having to swallow your medicine". When I stepped on my scale this morning it read 238. That is 5 pounds in two weeks. I'm ready!

Sunday, August 24, 2008

I Believe There are Angels Among Us

Vince and I were sitting in the sun room this morning admiring his tomato plants when the phone rang. Lo and behold, I recongized the voice immediately. It was a young woman, I won't share her name as you will understand, who worked with Vince at the cement plant. I met her first when Vince and I were dating and immediately loved her warm smile and gentle heart. She has gone through so much in life and we have watched as she celebrates 20+ years of sobriety and has found a gentle spirit to share her life. I don't think we had met him before today. As we conversed, I began to share my banding experience thus far and I made the remark that I have a fear of failure. This gentle angel walked over to my chair and knelt before me in prayer to our heavenly Father. The tears ran down both of our faces as we embraced. Now I ask you, did not God bring her and her husband to town today to come and visit us and touch my life with His spirit? If she has faced an addiction and walks each day in faith, then I believe I can also succeed. Thank you Lord for placing this person in our lives and sending this angel to enliven my spirit.

Friday, August 22, 2008

5 days until. . .

I will calibrate my scale on Wednesday by weighing before we travel to the hospital and then comparing to the hospital scale. This morning my scale said 239 which made me feel good. I have to say that I was really down last night over the diagnosis and then when Vince came home from the pharmacy without the medication I just lost it. It seems the pharmacist couldn't release the three antibiotics because the insurance had to approve the order. I can't believe a hospital that is so patient friendly can have the same name as an insurance company that constantly puts roadblocks up for its clients. I am inclined to write Mr. Sanford myself and tell him I think the insurance company could contaminate the reputation of his exemplary health facility. Enough ranting! I don't think hospitals should be allowed to have related insurance companies. Tonight I had my "last supper". We had friends over for dinner and I ate my last regular meal for awhile. I put some of the left over pork loin in the freezer and will grind it up when I am able to reintroduce solid "mushy" food. I also drank one last carbonated Diet Rite. Actually it didn't really taste that good.

Thursday, August 21, 2008

Oh Good Grief

It has been a very busy week and of course, I forgot to plug in my phone to re-charge it. Thus, when I came home today, Vince asked if I had my phone turned off. It seems that Karen, one of Dr. Glatt's nurses called and my blood test for H Pylori had come back as positive. Borderline, but positive. Well, needless to say, I immediately had to do some research on this. I won't bore you with the details about this stomach bacteria, but suffice to say we heard about it at the baratric workshop and it can cause complications. Why Me? Well I have to take a two week regimen of antibiotics and the office had called my pharacist because of course, they have to be liquid, crushable, or soluble from next Wednesday on. And of course, because of my allergies to some antibiotics, they had to fuss about getting the right combination for this "testy" bacteria. It seems I will be taking three medications. The GOOD news is that this will not effect my surgery date. I was relieve to hear that. I must admit I am bummed. One thing to worry (think) about. I certainly have had no symptoms of this one! I have been drinking loads of water the past two days and feel really good about that. I seem to be very consious about what I am chewing. I think I will get on the scale in the morning and see if I had lost anything on this "less than 1200" calorie diet I have been following.

Monday, August 18, 2008

V8 juice never tasted so good!

I am having a great day. I am not hungry and seem to be doing OK on the liquids. Just have to allow more bathroom time in my day. I am also trying to sip and not guzzle. That is a challenge. I have been so cognizant of how rushed our days are. I am really going to have to slooooooow down. I have been able to stay below 1200 calories for three days now. When I went to exercise tonight I noticed that my energy was low. I only biked 7.6 miles in my 30 minute ride. Tomorrow will be more difficult because I have to travel to Pierre for a meeting. I am certain they will serve lunch at the meeting and I am really going to have to pick. I am ready for it.

Saturday, August 16, 2008

11 days and I am counting

I started my food journal again yesterday. I am trying to stay below 1200 calories this weekend and then on Monday I will start the liquids. Dr. Glatt doesn't ask his patients to do that but I want to be certain my liver is as small as it can get. You see, I am short! I used to be "five foot two, eyes of blue" but now I measure 5 foot 1 inch and I don't have a lot of inches between my neck and crotch. When I carried my children many years ago I can remember struggling to get air in my lungs. It won't be bad to be on liquids. Maybe I will drop a pound. I also exercised today. I rode the bike for 30 minutes and logged 8.7 miles. I was watching the Olympics so maybe I was inspired. I must admit it gets easier to bike for 30 minutes. I have been working up to more miles in that amount of time. Next, I will stretch the time to 40 minutes. That is the Doctor's goal for exercise everyday. Keeping busy on the weekend will be the key. I have quilting, knitting, and reading that I can do. Maybe I will get my Christmas gifts done early this year. I was thinking about Christmas today. I love Christmas. I love decorating our home, selecting gifts, and listening to all of the wonderful music. New Years Eve will be exactly 18 weeks from my surgery date. I wonder if I can lose 36 pounds by then? I would be very pleased to be able to do that. I also took time to eliminate all 3X clothing from my closet. Those clothes are getting a little baggy and summer is drawing to a close. I don't think I will advertise on Ebay again as those ladies last fall STOLE my clothes. One of the ladies at the meeting on Thursday said she had a rummage sale for her clothes and made $500. I guess I will have to put in the effort and do that. I know plus size clothing is expensive and I have some very nice professional clothing.

Thursday, August 14, 2008

13 days, but who is counting

While I was driving between meetings today, drinking my water, I noticed that Vince had called on my Blackberry. I quickly called him at home to see what was up. He calmly announced that I had received a letter. It was my approval letter from the insurance company! I must say my heart skipped a couple of beats as this is what we have been anxiously awaiting. I immediately called my GP's office to let her know we had succeeded. Then I called Thomas, my trainer, and it was so evident that he was excited. He will continue to be my lifeline to health. I have been reading and responding to a google blog called SD Bandsters and it seems that most of the participants had their surgery here in Mitchell. They meet as a support group at the hospital, so I decided to go tonight. A very nice group of people! Dr. Haley, the surgeon at the hospital, spoke with the group. He talked about issues with not having success. It was most interesting to hear what the participants were experiencing. This is a really big deal! One gentleman said it was the best thing that had ever happened to him and he would do it again. That was comforting to hear. I do believe talking to people who have had the experience and are going through the same things I am will be helpful. However, "misery loves company" does not fit my thinking. I feel like this is a privilege I am being given to get a second chance for health. I plan to do things right. Check in a month or two from now and see if I am still as optimistic. God give me strength!

Wednesday, August 13, 2008

More Information

I was looking for some of the resources they gave us today and I found this website that has a video of banding. Vince and I watched a live video when we went to seminar last January. This is animation and my port will be in the middle of my stomach, not off to the right or left as in the video. It is interesting. http://www.bariatricedge.com/dtcf/pages/3_GastricBanding.htm?pgn=3

14 days and counting

Today was my bariatric class at the hospital. It started with the one hour drive and I did a breakfast bar on the way. As usual we checked in with the wonderful staff at Sanford. I am so impressed with the courtesy and sincere caring manner each of them possess. I had an EKG, talked with the pharmacist about medications, blood drawn, and then a chest xray. About the time we arrived at the actual classroom where the other three patients were waiting, the nurse who had drawn my blood came in with some orange juice. My blood sugar was low. This surgery might be coming just in time. The bariatric coordinator led a discussion about the surgery, the risks, and the diet necessary to be successful. They had encouraged us to bring a significant person with us for support. I am certain I had the best person in the room. Vince was right there taking notes, nodding, and looking at me over his glasses to reinforce a point. After class I had my last visit with Georgia. She weighed me and wished me luck! I have been very tired today. Don't know why. I went to the rec center and rode the bike for 30 minutes and logged 7.5 miles in that amount of time. Now I am taking some time to reflect. The bariatric coordinator asked us to write three words at the top of a paper: STRESS, ANGER, BOREDOM. I think I would also add SAD. Those are the emotional triggers that cause most people to eat. Things like too many phone calls or interuptions in a row, too many meetings or appointments in a day, and not being organized cause me stress. I don't have too many anger issues. I become sad when I have had a disagreement with a family member or when I don't feel good about myself. Boredom sets in while I am driving in the car or watching TV with no hand work. She then said to list the foods that one goes for at these times. I would have to say: donut holes, bakery rolls, chips, diet coke, and at the very worst times, CHOCOLATE. In the last column we were to write some options of behavior we could do instead of eating. I had already begun to contemplate strategies for these events. Obviously, I could go for a walk (even at the office, I could walk around the block to clear my head). I mentioned that quilting has become a hobby as is knitting and I don't eat when I am doing these activities. Our great room where our large screen TV resides is part of my kitchen. Now that is nice when you are entertaining and everyone wants to gather around the cook. BUT, when I watch TV in that room at night I tend to graze. That's a no-no. We have a television upstairs and that is going to be my strategy for late night viewing. Away from the food! I think one other strategy I will employ is calling a friend. I have some (LOL) all around the country and so they may be hearing from me more often while I break the emotional eating habit.

Sunday, August 10, 2008

Life Means So Much by Chris Rice

Every day is a journal page
Every man holds a quill and ink
And there's plenty of room for writing in
All we do is believe and think
So will you compose a curse
Or will today bring the blessings
Fill the page with rhyming verse
Or some random sketchings
Teach us to count the days
Teach us to make the days count
Lead us in better ways
Somehow our souls forgot
Life means so much
Life means so much
Life means so much
Every day is a bank account
And time is our currency
So no one's rich, nobody's poor
We get twenty-four hours each
So how are you gonna spend
Will you invest or squander
Try to get ahead
Or help someone who's under
Has anybody lived who knew the value of a life
And didn't He give His own
To show the worth of yours and mine?
Every day is a gift you've been given,
Make the most of the time every minute you're living

Saturday, August 9, 2008

Rambling




Today was a beautiful day to be outside. My friend Sara and I ventured to a wonderful outdoor quilt show. My knees held up pretty well with the walking. It was slow and leisurely up and down the grapevines. I have always loved to knit but this winter I started quilting. As I just put the binding on a baby quilt I am making for one of my daughter's friends' son, I realized how much this hobby might help me in my effort to change my lifestyle. If one wants to make a beautiful quilt, one should not be nibbling on food. You don't want to wash it before it is finished. Also, quilting forces me to think about what I am doing and that should help occupy my mind. Speaking of mind, in many of the blogs and discussions about lapbanding I have read comments about the psychiatric evaluation. You know, I think that might be the most sensible task and insurance company could require of those considering banding. I say that because I do believe one has to be in the right mindset. Sanford Health refers their patients to a clinic where they use the Minnesota Multiphasic Personality Inventory as a screener. Coupled with the results of this 567 True/False question screener, the psychologist can assess mental well being. I know there have been times in my life when depression and anxiety have stimulated my eating habits. They are looking into a patient's coping skills and mental readiness. She asked me questions about any stressors present in my life at this time and my ability to adapt to new things. I believe being mentally ready is key to success. I also believe I have to want this for the right reasons. A positive attitude about the ability to succeed is one thing that I identified early on and have been working on to this moment. I have been reading a discussion where one of the participants did not have an eval nor any counseling before her surgery. She was contemplating if that might have been a good idea. I think anyone considering this surgery certainly needs the support of their significant other, at the very least. You need to converse about your doubts and voice your fears. Vince is my rock! He is my biggest cheerleader and he wants so much for me to succeed that he sometimes fringes on what Georgia called "babysitting". I have to be the one to make responsible decisions. This kind of support of family and friends is crucial. I also believe some individuals feel so much better when they are sharing with other people who are going through the same experience. I think that is why one finds so many lapband discussion boards exist.

Friday, August 8, 2008

Pictures are worth a thousand words

I don't believe most people know how hard it is to look at a picture of yourself when you are obese. After all, the purpose of a picture is to capture beauty or a special moment. Two years ago, I sat before a window and was looking at my toddler grandson watch the rain. My husband captured the beautiful moment. Later, I cropped the picture and captured the picture over on the left of the blog entitled "At My Heaviest". Just one month before that picture was taken, we had gone for a long walk in Minneapolis with my brother and his wife. I struggled to breathe. My knees were killing me. I stopped and looked at my husband and as I cried I declared I was going to start exercising. That was two years ago, and I have exercised. I have lost 22 pounds but we took this picture tonight in our home. Same shirt, same hair, a new scar on the neck from thyroid surgeries last February, and the same overall grief of obesity. So I say, here's to a new beginning. I will share another picture one year from today. We'll see how far I go. I want to take walks with Vince whereever he wants to travel (even though he won't fly) I just want to be able to watch my five grandsons watch the rain outside the window and play ball and open Christmas presents and graduate and walk their brides down the aisle and whatever other moments God grants to me in a healthier body! This picture is worth a thousand words in my head - You can do it! Believe in yourself! You aren't going to fail! You will be successful this time! I have a big heart but my body doesn't have to match! God give me strength.

Thursday, August 7, 2008

Georgia On My Mind

I've said it before, "there is an almighty plan" and I so believe that when it comes to Georgia. When the insurance board directed me to see a clinical nutrition manager twice a month for six months, it happened that when I made the first appointment, Georgia was the one assigned to my case. From the first visit, I knew my experience with her was going to be positive. She is a delightful person who listens intently to your conversation and then gently nudges you to make some changes. It was quickly apparent she knows "her stuff". Her initial suggestion to begin to do better planning for my evening meal was the first challenge. Rather than just come in and grab anything I could find in the pantry or the refrigerator, it made sense to plan better, shop for good choices, and then select those items to eat. We have talked about chewing more and eating more slowly for six months. When I sit down to eat, I think of Georgia and her smiling face, telling me to chew, chew, chew and become more sensitive to when I feel full. We have talked about counting calories and quite frankly, even when I faithfully ate only 1200 calories a day, I haven't moved the scale. Georgia just looks at the bar and now we giggle and say "it doesn't matter". She has given me so many ideas about changing my behavior. She encourages me to select alternatives to "pop" so that I don't have to quit "cold turkey". I am almost there. Last week when I was sitting in the airport, I watched for obese people carrying diet coke. It is almost a 1:1 correlation. To think, I used to think nothing of drinking a six pack a day. Now I am sitting here with a fruit punch G2. There are people God puts in our life for a reason. I consider Georgia to be one of my angels. I hope to continue my friendship with this caretaker. I will miss my bi-monthly meeting with her as I believe these appointments have been crucial in my preparation for banding.

Wednesday, August 6, 2008

Sign Me Up

I have been waiting for today. I had my pre-op appointment with the surgeon who will do my lapbanding. I first met Dr. Glatt in February when I was diagnosed with a large node on my thyroid and he was the recommended surgeon. I am a firm believer that God has a plan for us and late in January, Vince, my husband and I had attended an introductory seminar at Sanford Hospital on bariatric surgery. That seminar was conducted by Dr. O'Brien who also practices in the Surgical Tower at Sanford. Back to Dr. Glatt! When I met with him in February before my thyroid surgery, I told him I would see him again when I had insurance approval for banding. He said, "begin with Weight Watchers now, because it will take a year". Needless to say, we were both happy to be meeting today as it has only been EIGHT months. Today we talked about the choice I have made about lapband rather than the Roux-en-Y procedure. He explained how sweets (and that is my downfall) go through the pouch in both options. I must admit, the idea of becoming so sick that you decide sugars are not worth it, sounds tempting, but I really believe I am ready to make the commitment necessary to use the band as a tool and not a crutch. When I asked him when I had to make the final decision, he said "right now". I said, "the lapband is what I want to do". Now that I am scheduled for the 3 hour class next Wednesday with the Bariatric Coordinator, I have to say this whole thing is really becoming real. A year from now, I will look back and know that my belief in myself is the most important part of this whole experience. I am committed to being healthy and able to watch my children and their children grow older along with me.

Tuesday, August 5, 2008

In the beginning

In October, 2007, my General Practitioner wrote our first letter to the insurance company to apply for approval for the lapband surgery. It was denied, of course because even though I had a BMI of 49, I did not have any co-morbidity. As far as I was concerned that is a blessing, but the denial was disappointing. The insurance company wanted me to go through one full year of Weight Watchers before approval. We continued to pursue the insurance procedures and finally, on February 23, I testified before a review board of 3 physicians and tried to convey my needs. I am 61 years old and have struggled with weight all of my adult life. I have tried Weight Watchers, Optifast, NutriSystem, hypnosis, counting calories, etc. Two and a half years ago I made a genuine commitment to change my lifestyle. I began to exercise with a personal trainer. He, too, had tried various things to assist me with weight loss. On February 25th, I received a letter from the insurance with a real compromise in my opinion. I had to continue to exercise at least 3 times a week, see a nutritionist twice a month, have a psychiatric evaluation, and get approval from my endocrinologist and surgeon. All of this had to transpire over the next 6 months.