Update on recovery, thoughts on exercise, and what I am eating at one week out

As of yesterday, I am pain med FREE! Not even Tylenol! :happydance: I will be one week post op tomorrow, and I seriously can't beleive how great I am feeling, especially when I remember that my worst day (last Wednesday) pain-wise was just 5 days ago. Yesterday my husband and I went to see a movie, and I was able to wear jeans instead of sweats/yoga pants, which was nice - wearing yoga pants in public makes me feel like a schlub and is one of those things that I have always avoided doing because it seems like a "fat person" thing to do. I still can't wear a bra because of the incisions higher up, but I think that's just a matter of a few more days now.

I walked for about 15 minutes today, and it wore me right out. It pretty much just made my stomach muscles really fatigued (not painful though) which is a reminder that as good as I am feeling, I AM still healing. One thing that I am really looking forward to is being more active, and being able to walk all day. I'd like to take an urban vacation to NYC or another big city and walk all over the place, just because I'll be able to. The big difference, this time, is that I KNOW it will get easier. With all of the other diets I have done, it's been the big "if"...IF I keep doing this indefinitely, it will get easier. This time, I still have a list of things that I have to keep doing, diet-wise, but it's much easier to do it (and for the first few months, almost impossible not to) because I've got the tool of the surgery to help me. Being active is seriously my number one reason for doing this. I've been crippled by my weight my whole adult life. This is the most hopeful I've felt about getting free of this burden, EVER.

Changing the subject a little, I want to talk about what I've been eating during my first week post-op. I want to try to chronicle these things as I progress, both for my own memory and to hopefully help anyone who might eventually come across this blog.

In the hospital:
Water. Seriously. They gave me a tray with a pack of unflavored protein powder, some broth, jell-o, and Crystal Light. The thing is, I was allowed one medicine cup (2 tbsp) of any of those items per hour on day one, and 2 medicine cups per hour on day 2. The CL tasted bad (they made it according to package directions, which has always been way too strong for me), the broth was salty, the jell-o just looked gross. So I drank water. I mean, I wasn't hungry anyway. But I really should have tried harder to get some protein in. It was just 2 days though (I was not allowed anything at all on the day I had the surgery).

Since I have been home, and on "full liquids":

• Muscle Milk Light ready to drink protein shakes in Chocolate shake
• Click (Yeah, I am drinking caffeine. Just one every couple of days though)
• Optimum Choice 100% Whey protein, prepared with skim milk
• 1% cottage cheese
• plain greek yogurt (Fage, Chobani, etc - it has twice the protein of regular yogurt), sometimes mixed with a little bit of sf pudding mix and cool whip for a mousse kind of concoction
• a spoonful of cottage cheese warmed up with a little bit (like half a spoonful) of pasta sauce (for something more savory)
• Campbell's select tomato basil soup with unflavored protein powder added
• a fistfull of vitamins and meds, daily
• 3-4 bottles of grape Propel daily
  

So anyway, if anyone was curious what the first week looks like, there it is. I move on to purees on Thursday, which I am stupid excited about. I have big plans involving pureed beans.

I made it!

My surgery was Tuesday morning. Wednesday was an all around shitty day, but by yesterday morning I was feeling a LOT better, and I was discharged at about 4pm yesterday (Thursday). I'm a little sore, but not too bad. I've been getting a LOT of sleep, and I think it's been helping.

I have a crapton of meds/stuff to do/etc now. On top of my regular meds (except the diuretic, which they took me off of), I am taking Actigall twice a day, and giving myself twice daily injections of Lovenox. It's a good thing I'm not squeamish. And then I've got the walking, and the drinking, and the incentive spirometer, etc. But it's really not too bad, all in all.

The things I was most worried about was pain control, the catheter, and the drain. The drain ended up being no big deal at all. The cath wasn't a big deal either, and didn't really hurt to have removed, BUT I wasn't peeing enough after it came out and got very close to have to be re-cathed. Luckily I dodged that bullet, but just barely.

The pain management did turn out to be an issue. They gave me morphine in my PCA (patient controlled anesthesia) pump, and it didn't do jack. They finally switched me over to dilaudid, which has worked much better. I just have an odd resistance to pain meds. The dilaudid helps, but it doesn't make me stoned (which I guess it does for most people). I have 2 mg tablets here at home, and I took two every 4 hours at first, but now I am taking one.

Overall, it wasn't a walk in the park, but I didn't really expect it to be. I am glad to be feeling pretty good just a few days out.

Prepared.

I've been to the store. Three kinds of protein shakes (actually 4, there's one that isn't in the pic), Jell-o, fat free greek yogurt, fat free cottage cheese, decaf instant coffee (for adding to shakes), broth, a couple kinds of soup, propel, True Lemon (for flavoring water and possibly the yogurt).

In 48 hours, my life will have changed forever.

Three more days!

I'm coming into the home stretch! Tomorrow, Sunday, will be my last day of solid food for about a month! I've got 4 kinds of protein (3 powders and a 2 cases of ready to drink), and all of my vitamins are ready to go. This weekend I am working on cleaning the house, particularly dusting and vacuuming, to help keep my allergies at bay. I figure sneezing with 6 incisions is probably not going to be much fun.

I got a call today from my surgeon to make sure I am ready and that I know not to "pig out" (her words, not mine) this weekend. I respect her as a surgeon, but I resent some of the implications from her that I am "non-compliant" or "difficult". She lectured me about how the patients who do as they're told are the ones who are successful and don't have complications. This goes back, I think, to the fact that I have had some difficulty losing the neccessary weight prior to surgery. But you know...it's DIFFICULT. That's WHY I am having surgery. And I did it, even though it's meant hovering at well under 1500 calories a day (which is a huge deficit for someone my size). I kind of wish she would congratulate me on having lost 30 lbs on my own, and cut the lecturing. I am going to keep telling myself that she means well.

I got my call from pre-op on Friday with orders to be at the hospital at 6am on Tuesday. My surgery is officially scheduled from 8-12:15. It seems unreal that it's so close now. I've had a bit of anxiety, but not very much. I've read and researched and asked questions. I've chatted with friends and my therapist. I feel like I am pretty well versed on what to expect, and that helps me a lot in terms of not freaking out. And if I do freak out, when it gets a bit closer...well, I have Klonopin for that.

Here's my to-do list for the remainder of this weekend:

• go to the grocery store for skim milk, non-fat yogurt, cottage cheese, and broth
• launder the new nightgown, yoga pants, and pajamas that I plan to live in next week
• clean, dust, vacuum, etc
• organize the office/sewing room
• pack toiletry bag for hospital (cetaphil, 2-in-1 shampooo/conditioner, toothpaste and brush, lotion, chapstick, etc)

I think that's mostly it. I think I am ready. I hope I am, anyway.

Good riddance, 2009.

2009 was kind of a shite year for us, especially the month of November. In November, our sweet calico Random was diagnosed with cancer and subsequently died the day after Thanksgiving. And my mom crossed a line, leading to me not speaking to my parents, or seeing them for Christmas, which has made me very sad, but it's neccessary. Oh, and I ran out of Cymbalta and got an ugly 2-week-long reminder of the fact that I have a chemical imbalance that requires medication, and that I am incapable of controlling my anxiety. Because, you know, you can't really control your brain chemicals.

On New Year's Eve, I had an appointment with my surgeon's nurse practitioner, as well as a pre-op with anesthesiology. I still need to lose about 10 lbs. I am doing Atkins until my surgery date, because that's the only diet that I've ever actually lost any weight on. Mmmm...bacon. I took NYE and yesterday off, but I am back on it hardcore today and I need to stick with it so that I can at least get close to the pre-surgery weight of 370 that my surgeon wants to see.

I'm not really making resolutions this year. I feel like I am doing enough to make major changes in my life by having this surgery and going back to school...I don't really need to make a list. I feel like I have set a lot of big things in motion, and I am really feeling positive about 2010.

Preparation is the key to success...I hope.

I've spent a lot of time over the past few weeks preparing, planning, thinking, and...buying. I want to make sure that when I come home from the hospital, I have everything I need for those intial weeks. I am guessing I will be feeling pretty crappy, and I don't want to have to scramble around assembling the things that I need.

For Christmas, one of the things that I got is an immersion blender. It's a neat gadget that I can use to puree various foods when I am in the soft/pureed foods phase. (Tangent: for any of my non-op friends who are reading this, I have to gradually return to eating solid foods - first I will be on clear liquids, then full liquids [like cream soups and stuff], then soft or pureed foods, and finally back to solids.) I am trying to think of things that won't be gross pureed. A lot of the "recipes" I have found involve pureeing things like chicken or ham, which just seems disgusting to me. I am thinking refried beans, maybe chili, soups, stuff like that. I have some unflavored protein powder to add to foods during that phase so that I can amp up the protein, since I won't be eating much meat.

I've also ordered or purchased all of the vitamins that I will need. I found out a couple of months ago that my levels of vitamin D and iron are very low, and that's with a whole stomach! This brings home for me just how important it's going to be for me to take all of my vitamins every single day. I have to take chewables for the first couple of months, and then I can switch to a capsule if I want.

For a multi, I've landed on Trader Joe's chewables. They taste good, have a negligible amount of sugar in them, and have all of the nutrients that I need in a multi. I will take two of them per day, because I won't absorb as much after my surgery. I also need to take calcium citrate - not carbonate or any other form. The reason it has to be citrate is that other forms require stomach acid to break them down so that they can be absorbed, and I won't have enough acid to do that after surgery. I finally found a calcium chewable that doesn't taste like fruity ass: the orange flavored chewable from Building Blocks Vitamins (and if you click on the second link, and look on the left, they will send you free samples). I got the raspberry iron from them as well, which is also in the best form for WLS patients, ferrous fumarate. I will also take a sublingual b12 twice per week.

I've got some protein powder and some ready-to drink-shakes, but I will probably need to get some more. A lot of those things are pretty damn gross. The one that I have found that I like most so far is Click, but it really doesn't have the ideal nutrition stats for a WLS patient, since it has caffeine and 7g of sugar to only 15g of protein. It's really, really good though. Muscle Milk light ready-to-drink is decent, as is the Optimum Choice powder that I have. I think I may get one more thing just for variety, because I am going to have to consume a LOT of protein (what are you laughing at?) after my surgery, so that my body doesn't try to consume my muscle because it thinks I am not feeding it enough.

I guess the only thing I've got left to do is maybe make a couple of pureed meals to freeze. I think that those little half-cup gladware things will be perfect for freezing individual portions. I'lll wait and do that a bit closer to S-Day though.

Oh hai!

First things first!

The "SMO" in my blog title refers to the fact that I am (as of writing this) Super Morbidly Obese, which is defined as having a BMI of over 45. My current BMI is about 60, down from an all-time high of 65 a few months back. Three weeks from tomorrow, on January 19th 2010, I will climb onto an operating table and a very nice lady will rearrange my insides for me (laparoscopically, if all goes according to plan) so that I will, hopefully, lose a whole lot of weight. I need to lose about another 100 lbs (from my current weight) just to get to the point of being "regular" morbidly obese, about 200 lbs to be classified as "overweight", and about 230 lbs to reach "normal" status, which would be about 150 lbs on my 5'6" frame.

Having weight loss surgery is a pretty drastic step, but as you can see, I am drastically overweight. I am lucky that I have relatively few health issues as a result of my weight. My blood pressure is high and I have some joint issues, as well as asthma (which is mainly caused by allergies, and pre-dates much of my weight gain, but I am sure the extra weight isn't helping). But my cholesterol, A1C, fasting blood sugar, etc are all solidly in the normal range. I know that if I continue to be this heavy, that's not going to last forever. I've done every diet known to man, I took PhenFen, Meridia, and that stuff that makes you leak oil out of your ass. None of it has worked. I hope that this will.

I have a couple of major reasons for wanting to do this. The biggest one is that my weight is really, really slowing me down. I calculate my actions based on my weight. I avoid going to places where I might not have a comfortable place to sit, or where I might not fit in the seat, or where there will be tight spaces, or stairs, or long walks due to parking. I rarely go to the mall, or a museum. Concerts are iffy, because if they're sit-down ones, I might not be able to fit in the seats, and if they're standing ones...well, I'd have to stand. I only go to certain movie theaters, where I know the armrests flip up. I don't fly.

I want to be able to move, to walk, to go places without considering the parking situation, to travel. I am tired of being stared at by strangers, pointed at by children, treated rudely by salespeople. I am tired of being tired.

The second big reason is that my husband and I would like to start a family in a couple of years. At my current size, I am more likely than not to have major complications during pregnancy. Yes, having had WLS can also cause complications, but the statistics show that most women who wait the required amount of time to get pregnant have normal, healthy pregnancies.

This is a major commitment. I will have to eat a certain way for the rest of my life. I will have to take a pile of vitamins every day for the rest of my life. I will have to go to follow-up appointments, blood draws, support group meetings. To me, that's all worth getting my life back.