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It's only the beginning...

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ThriftyTheresa

Sunday I will begin my 2-week "diet" before surgery. My clinic does not require an all-liquid diet, just super low-carb - under 20g a day. This past month I have been working and lowering, and lowering, and lowering my carb intake. I haven't had any alcohol for over a month and I haven't had any sugar in a month except for fresh strawberries and a small squirt of whipped cream once a week. I know this is the final prep to shrink the fat around my liver and make surgery safer. I am taking this very seriously. Sunday is the final stretch toward this goal of getting surgery. It's been a hell of a 10 months to get to this point.

Saturday night, however...

I've planned for one final night of indulgence. My best friend and I are going to have a party night together. Have lots of alcoholic drinks, lots of greasy food at our favorite dirty diner, sing karaoke, and a final indulgence of Cheesecake Factory. She's not interested in surgery but she is interested in improving her health and losing weight. This Last HURRAH is for us both.

I have already picked up the Cheesecake slices for us and I will say that I almost didn't. I had some very intense feelings of embarrassment about going to the restaurant just to order from the to-go counter and take the big bag of cheesecakes on the bus home. I wanted to order the slices online using a delivery service app but the slices my friend wanted were both limited edition and only available in the store. I couldn't order them online. I work exactly 2 blocks away from Cheesecake Factory and walk by it almost every day on my way to the bus. In the 15 years I have worked here I have only been there probably 5 times. It truly is a rare indulgence, and that is 100% due to the shame I feel whenever I go there. I even felt shame about it the ONE time I ordered online to eat in the privacy of my home because a delivery person would had to bring it to me. The place is just so over the top with large portions and once slice of cake has the caloric intake for 2 whole days of food. The last thing I want is for someone to see me, the morbidly obese person that I am, buying 4 slices of cheesecake. The judgment of strangers shouldn't matter to me, and it normally doesn't, but I was really struck with the realization that I was judging myself. I was buying 4 slices of cheesecake with the full intention of pigging out on them this weekend. It's disgusting. I'm disgusted with myself. I don't even want to eat the stupid cheesecake now.

So me and my best friend are going to go out and have one last party night. I may or may not eat a greasy cheeseburger. I may or may not drink a lot of alcohol. The cheesecake might end up in the trashcan. I don't need it. I don't need it ever again.

ThriftyTheresa

Now that I've let everyone know my surgery date, people have been asking me "Are you getting nervous yet?" I always answer "No, I'm excited!" I've had abdominal laparoscopic surgery before when I had my tubes tied and fried. I know what to expect on surgery day and I know what I will feel like waking up from the anesthesia. I don't fear any of it. At least that's what I am saying to myself.

I woke up this morning from a very bad dream about the surgery. In the dream I was on what appeared to be a TV show being filmed in the hospital. There were bleachers of people watching the live filming. I was there as a "surgery success" patient and had lost a lot of weight. My tummy area was flabby with loose skin. I was wearing a very unflattering "dress" that looked more like a long T-shirt which clung to my flabby rolls, my hair was a mess like I just woke up from sleep. I had the distinct feeling I wasn't wearing a bra or underwear under this ugly gray t-shirt dress. I looked terrible but everyone was cheering and praising me for my great weight loss. There was a another woman there who was larger than my starting weight and she was fresh out of surgery and walking for the first time. She walked to me on the other side of the stage and we hugged and the audience cheered for us. All the while this is happening I keep thinking to myself "I don't understand. I just had surgery yesterday. How did I lose this weight? Why do I look like this?"

Then I was talking to someone at a control panel-type desk in the filming studio and noticed a piece of paper, or a newspaper type thing, and saw the date was in February. My mind knew my surgery was in July but the date is telling me an entire 7 months had passed. I didn't remember anything past going to the hospital and going under. How had all this time passed?

I couldn't find my father or any friends. I was back in my hospital room talking to a nurse asking why it was February. Was I in a coma all this time? What has happened to me? Why am I here? Where is my father? The nurse just stared at me for a long time while I was crying and asking these questions. Then she said "I don't know why you're so upset. We're taking care of you. Why don't you just take some more drugs and go back to sleep."

Around that time I woke up. It's been a long time since I've had such a vivid and upsetting dream.

So obviously from this dream I must be more scared than I realize. There are clearly feelings of not being in control of my health or my body. When the nurse told me to take more drugs sounded accusatory like I had become a drug addict. There were feelings of vulnerability being exposed to an audience and the ugly, unflattering dress I was in reminding me that I may be less heavy but I am still unattractive and I don't want people looking at me.

So what I take away from this is - sure I am probably a little scared of the surgery, but I am more scared of what will come after the surgery.

Or maybe it was just a dumb meaningless dream. I'm not going to let it bother me anymore.

ThriftyTheresa

Last week I had an interesting experience and it was very helpful for me as I look forward to my own surgery. I visited a patient who just had Sleeve surgery with my surgeon and got to help her be discharged from the hospital.

We have a FB group made specifically for patients at our hospital. No Drs or Nurses are involved, it's just for patient support since we all have the same clinic guidelines and education we can help each other. A woman posted Tuesday morning that she was getting her Sleeve surgery that afternoon and she was all alone. She travelled from a different part of the state to be here - about 300 miles. All of her family are in another state even further away and she was going to be completely alone for a week and staying in a hotel. That broke my heart.

I live very close to the hospital (less than 2 miles) and I reached out to her and said I would be happy to come visit her on Wednesday afternoon. No one should have to go through this alone. When I arrived it  turned out the lady was ready to be discharged and was already packing her bags. Since she had the sleeve it was just one overnight for her and she was good to go.

She was staying at a hotel that is just a couple blocks from the hospital and they sent a shuttle to pick us up. I carried her bags. She had already checked in to the hotel before the surgery and had the room filled up with protein drinks, water, soups, broths. The hotel had a little refrigerator for her and a microwave. She was all set up.

After getting back to the hotel she was still feeling really good so we took a walk down to the drug store and got her prescriptions filled. Returning to the room we chatted a while until she was eventually ready for a nap.

She spent a couple days recuperating and I visited her again on Saturday and she left Sunday to finish her recovery staying with a friend in another city further away. She will have her 2 week post-op check later this week and fly home after that.

All in all I found it very helpful for ME to see what my experience might be like. I will have 2 nights in the hospital because I am getting RNY and she got the Sleeve. It was a nice way for me to see the behind the scenes action from the view of a patient. Seeing the recovery room, the location we would be in the huge hospital campus, met a couple nurses who were assisting her. Seeing how well she was feeling the very next day was amazing! I could not believe how good she was feeling and ready to walk to the pharmacy. She wasn't feeling nauseous or in pain so that really gives me hope I will have a good experience myself and will not be completely incapacitated. Talking to her the next few days was good to hear about the liquid diet, the things she was enjoying and not enjoying drinking. Hearing about her sleep and sleeping positions. She had a really good attitude and I think that also makes a lot of difference.

Overall it was a good experience for me to help her and I hope I made her recovery a little easier being in a strange city all alone. I now feel more prepared than ever for my turn on the Losers Bench!

ThriftyTheresa

After 2 weeks of waiting for insurance approval I hadn't received any phone calls with confirmation. I had a check-in appointment yesterday and got the good news that insurance has approved the whole shebang and we chose a surgery date of July 10th.

It's another 6 weeks of waiting - and preparing -  but I am ready!

Part of the appointment yesterday was a group class with other patients where we went over the 3 diets we will be on. 2 week low-carb "Atkins" diet (staying under 20g carbs a day), 1 day clear liquids before surgery, and the 2 week post-op liquid only diet. 2 weeks after surgery I will have another class to take on diet advancement to pureed and soft foods.

I loaded up on protein and vitamins at the clinic store. We go to sample a lot of the drinks and chewable vitamins before we purchased so that was very helpful. I was surprised to see the prices were a good $5 cheaper than Amazon for most products. The Unjury chicken soup might be the best medical grade food product I have ever tasted! Funny because the Unjury protein powders are absolutely vile!

Anyway...it's happening! Now I just need to get all my ducks in a row at work and contact the powers that be regarding time off.

I'm almost there!

ThriftyTheresa

I thought 2 weeks ago the hospital was going to send al my info to insurance but that didn't happen. Instead they gave me another appointment for a "Final Review". So yesterday I had my final review with the surgeon and signed all the paperwork permitting him to poke holes in me and play with my guts. My Case manager at the clinic is NOW submitting everything over the insurance. She told me it could be 2-3 weeks for approval. I called and spoke to my case manager at the insurance company and told her to expect everything this week. She thinks it should only be 2-3 DAYS to get the approval so I am hoping she is right saying DAYS instead of WEEKS.

I'm already scheduled for a pre-surgery checkup and a couple pre-surgery classes on May 24th. After taking those classes I will be clear to have surgery anytime in the next 30 days.

The journey to get to this point seemed to fly by - been working on this since September last year! This last little bit of waiting and hoping and praying and waiting some more is driving me insane. LETS GET IT DONE ALREADY!

ThriftyTheresa

Had my last appointment for my supervised weight loss yesterday. Since September I have lost 29lbs. I have lost 39 lbs from my highest recorded weight in 2015. I'm happy with the results and my medical team is happy with me too. Now I have to wait for the call from my nurse coordinator about submitting to insurance and choosing a surgery date! So happy that this 6 months is over with. It's been up/down, good/bad, but overall I am grateful for this period of time to lose some bad habits, start some better habits, try out new foods, become more active and educate myself about the surgery and what my life will be like post-surgery.

So excited to go forward and get this done!

ThriftyTheresa

Feb 28th was the end of my 4th month of the Supervised Weight Loss required by insurance. I did not lose any weight - however - I did not gain any weight, either. I weighed in at exactly the same (give/take a few ounces) as I did at the end of January. I am still at 35lbs under my highest weight. I am not celebrating and I am not upset, either. I still have 2 more months of supervised weight loss before surgery and I am focused on losing more between now and then.

February 3rd was my birthday and I allowed myself to indulge this month without guilt. I had cheesecake multiple times during the month, I had friends take me out for drinks, nachos, brunch throughout the month. My father and I went to Las Vegas to see Cher on Valentine's Day. We ate mostly convenience/fast food and I had cocktails in the casinos. I splurged on Chinese food, Indian food, and Pizza at home. But every time I ate/drank something I tracked it on MyFitnessPal. All the good and all the bad. I tracked it all. I still had "high protein/low carb" on my mind every time I make my food choices. I allowed myself to splurge on certain meals and I would balance that out with healthy choices for the rest of the day/week.

The nurse who I met with for my appointment did not shame me for my "bad month" but actually commended me that I did not gain. She reviewed my entire month of food - all the bad and the good - and she says it shows I can do "maintenance". I don't quite agree with her, because frankly there were times where I was a complete hedonist and binged without abandon. That is something I don't want to do again.

I am not a fan of the "everything in moderation" mindset because I certainly don't want to talk myself into destructive behavior after I have surgery. I don't want to look back on my "last hurrah!" and my "food funerals" had this month and think to myself that it would be OK to go back to poor eating habits with the false bravado that I could "cheat" and not gain. And the nurse said it was OK to cheat from time to time. That false feeling of security is how other WLS patients get regain. I don't want to even entertain that idea that cheating is OK.

I'm a food addict. You don't tell a drug addict that it's OK to have a little heroin from time to time just to treat yourself.

My eyes are firmly on the goal of losing more before surgery. So March 1 I am back on track and so excited to be in Month 5 out of 6!. February is now over and I am back on track. Packed breakfasts, lunches for work. I have healthy dinners planned all week. Anyway...onward and downward!

 

ThriftyTheresa

I've been pretty secretive about this weight loss stuff. I have only told 5 people so far; my father, 3 close friends, and 1 coworker. I keep all of them up to date with my monthly weigh-ins and they have been very supportive of me. I am hesitant to share this process with anyone else - specifically my coworkers because of how judgmental and gossipy they are. I'm wondering at what point people will start to notice my weight loss, my dietary changes, or anything else.

Right now, at a 35lbs loss from my highest weight I can see the differences already in the mirror. My double chin is going away. My clothes are baggier and loose. I don't want to spend money on new pants yet so I have to wear a belt to keep my baggy jeans up. My winter coat is at the point where it is so big and baggy it's not keeping me warm anymore because it puffs out like a tent because it's not touching my hips or waist anymore. I know I am changing, but I am also actively looking to see my changes. No one looks at me like that. To the world, I'm just fat.

10+ years ago me and my best friend worked really hard together and we both lost a lot of weight. We were cooking together and working out together. She lost 60lbs and I lost 50lbs. We were both wearing clothes 3+ sizes smaller. We were feeling great, looking great, and so happy with our progress. We planned a lunch to meet up with a couple of friends we hadn't seen in a long time. We were so excited to see them and excited for them to see our great weight loss. We were both expecting a WOW moment when they would walk in and say "You guys look great!" but that never happened. Neither of the women commented on our appearance for about 2 hours. So we started talking about how we had both lost a bunch of weight and both of the women were all "Oh! Wow! Good job! That's great!" but neither of them realized anything was different when they saw us or hugged us. We were both still fat. We were fat, lost a bunch of weight, and were still fat. All these women saw was me and her were fat. Not as fat as before? They probably couldn't tell the difference. It was very discouraging for us both. We both left that lunch feeling sad that our friends did not have the WOW reaction we were expecting. And not long after that we both started slipping on our healthy eating and we both stopped going to the gym. We both regained all our lost weight plus more over the years.

I've talked about my coworker situation before. I'm not friends with these people. I'm not planning on telling them a dang thing except I am taking time off work for medical reasons. But when will they notice? I've lost 35lbs in 3 months. Has anyone noticed? No one has said anything. On one hand, no one is gossiping about me to my knowledge. If they were gossiping like they usually do I would have heard about it by now. On the other hand, they didn't bat an eyelash when I severely sprained my ankle back in September and was wearing a brace on my leg for 6 weeks. I still limp from time to time and no one ever asks me if I am OK. So what would it take for them to notice me losing weight if they are not even going to notice I have a leg brace on for 6 weeks.

When I lose 100lbs I will still be 253lbs. I will sill be clinically Obese. The closest I have been to that weight was 275 which is where I was when me and my friend had that lunch with those blind ladies. That's only 22lbs different. So if no one noticed my weight loss when I was 275, will they notice when I'm 253? Could I lose 100lbs and not have anyone notice?

Keeping this a secret feels safe to me because I'm safe from judgment, but not being acknowledged for my hard work will be discouraging. I wish I had more people that I felt comfortable sharing this with. I guess that's why I come to forums like this and write blog posts to get my feelings out because I really don't have many safe outlets for my thoughts and feelings, especially with this sensitive and controversial topic of weight loss surgery.

 

ThriftyTheresa

Monday was my 3rd pre-op weigh-in - I lost 5.2lbs in January. That makes 25lbs lost since October and 35lbs lost since my highest weight in 2015. Yay!

Not as great as last month when I lost 10lbs, but I am happy with 5lbs. That's more than 1 pound per week so I am pleased. That is healthy, normal weight loss. I met with the dietician again for this appointment and she was super happy with my progress. Went over my month of food that I printed out from MyFitnessPal and she liked what she saw. She was proud that I was tracking everything, even the "bad" days where I splurged and went over my calorie count or carb count. We discussed vitamins and I got some samples of the chewable vitamins I will need to use after surgery.

Still waiting for my first counseling session. It took 3 weeks for the counseling center to call me and make an appointment. And now I get to wait another 4 weeks to have the appointment. I'm glad I don't have a mental health issue that needs immediate attention because this place is freaking slow to get anything done. I'm trying not to regret my decision to stick with them and wait for my appointment instead of saying "forget it!" and finding somewhere else to go. The location is convenient between work and home. Hopefully the therapist they assign me to is a good fit and it will be worth all this hassle in the end.

Onto Month 4! February is my birthday month and I have a trip to Las Vegas coming up around Valentine's Day. Hoping Sin City doesn't suck me in and ruin my healthy eating. I'm going to bring protein powders and healthy snacks with me. I'm only travelling with my father so the alcohol drinking will be minimum but I will be sure to log it if I do have any. And I'm sure I will burn a lot of calories walking around like I always do on vacation. Looking forward to it.

ThriftyTheresa

I have never been a cook or interested in cooking. Funny enough, I love watching cooking shows and food videos online. Probably because I am a food addict rather than a chef. With my life so far I pretty much only cook when my Dad is coming over to visit. I rarely cook for myself because I live alone and hate the cleanup afterward. Why dirty the dishes when I can grab some fried chicken at the deli or a bowl from Chipotle? This is the kind of thinking I am trying to get away from.

During this pre-op weight loss I am re-learning the types of food I should eat, specifically protein rich and low carb. I've done low fat, low sugar diets before. Having the emphasis on the high protein is new for me. I never realized I was not getting enough protein in my diet, but it makes sense once I think about how much pasta and rice and potato and breads I would usually gravitate toward. Meat was an after thought. But that is changing. I've been reading a lot of blogs and watching a lot of videos for food inspiration and recently I have been trying to cook some stuff at home that I can take to work for breakfasts and lunches.

My favorite thing to make, thus far, has been a chicken crust pizza. Very good and satisfied the pizza cravings while packing in the protein. Last night I tried making cauliflower cheesy breadsticks - dipped in marinara. Those were good too for a pizza craving. I will be trying both of those again because they were very easy to make. I tried making a cauliflower fried rice a couple months ago and I need to try that again. I wasn't happy with the flavor, but flavor can be changed with better spices and ingredients so I don't want to give up on that. Try, try again.

My other favorite thing to make is ANYTHING I can put in a muffin pan. Great portion control. Easy to refrigerate and heat up. I've made 3 different types of egg muffins - a savory Chinese-inspired egg foo yung cup, a fresh crab , spinach & egg cup, and a basic Ham, egg, veggie and cheese cup. All of them great for breakfasts, lunches, and dinners! I also made cheese stuffed turkey meatballs/mini-meatloafs. Those were fantastic.

Last weekend Dad was over and I baked some salmon filets. I forgot how much I love salmon! And it's SO easy to bake. I need to have more of that in my life.

I've never cooked for fun before. Cooking always seemed like drudgery but I am changing my mind about that. And as long as I do the dishes while the food is cooking/baking then I don't worry about the mess(I have to wash by hand, no dish-washer machine). And I mentally count it as activity points because I'm in the kitchen on my feet for a hour or so and not laying on the couch being a potato.

Ugh...don't think about potatoes. I miss potatoes. Is there such thing as low carb potatoes? I'll have to research that.

 

ThriftyTheresa

Saturday I attended my 3rd WLS support group meeting at Swedish First Hill in Seattle. The topic of the day was GOALS and setting SMART goals.

The acronym SMART has several slightly different variations:

S - specific, significant, stretching

M - measurable, meaningful, motivational

A - agreed upon, attainable, achievable, acceptable, action-oriented

R - realistic, relevant, reasonable, rewarding, results-oriented

T - time-based, time-bound, timely, tangible, trackable

Right now my first goal is to lose at least 5lbs per month for the next 4 months. That would put me at 40lbs down, and under 300lbs, before we schedule surgery. I am already at 20lbs down and I am confident this 40lb loss is achievable. The last of my 6-month supervised weight loss appointments is on April 26th, 2017 so that is my deadline for this goal.

Seems reasonable and achievable. More goals will be set up post-op, of course.

In other news, still have not seen a therapist. Had the initial assessment/intake appointment 2 weeks ago and they have not contacted me to meet with a counselor yet. Kind of peeved about that. After we talked about Goals at the support meeting the ladies who run the classes asked us for suggestions for future groups and the overwhelming response was that everyone needs more emotional support and would like the Psych team to present some topics - most classes are run by the Nutritionist team. Most of the attendees are post-op and they are struggling with a lot of emotions. This is why I really want to get a grasp on this emotional stuff while I am still pre-op, to get some coping skills to help me once I become post-op. If I don't hear from the Counseling center this week I am going to get some other referrals from my insurance and find another place to go.

ThriftyTheresa

Friday Dec 30th was my Month #2 Medically Supervised Weight Loss appointment. I lost 9.6lbs in the month of December! That's amazing considering I had a Las Vegas vacation where fast food was the daily routine and I splurged on having wine every night. So almost 10lbs down from last month - that's nearly 30lbs from my highest recorded weight in 2015. I'm so pleased with myself! And yes, I did eat that Indian food on New Year's Eve and it was delicious!

The nurse went over - in HUGE detail - my blood work/labs from September. Pointing out things we want to watch for in the future. I have never had someone explain lab work so completely and really help me understand those numbers. For example, my thyroid numbers have always been "within acceptable range" but she pointed out that the number I have, although within range, is something to watch. Also my cholesterol, even though I have never been told about this before. We will do bloodwork again in February and be able to compare between September and now.

She also provided me with an awesome printout of all my stats from my 3 appointments in October, November, and December to show how EVERYTHING has gone down - weight, measurements, fat %, BMI, and even blood pressure. She says since October I've lost 3.95% of my weight. They like to have at least 5% weight loss before doing surgery and at this rate I will be a star patient. YAY!

So now I am officially in Month 3 of my 6-month plan toward surgery. I'm so happy with what I have accomplished thus far. Onward and upward (or is it downward?) Happy 2017 everybody!

ThriftyTheresa

Nothing much to report this month. I actually have my 2-month weigh in later today at the surgery clinic but felt like blogging now instead of waiting until afterward. Haven't started therapy yet either. Due to holidays, et. al. they couldn't get me scheduled until Tuesday Jan 3rd. So next week I imagine I'll have a pretty big update.

This year has been pretty average. That's a good thing. Nothing terrible has happened to make it bad (other than the Presidential Election) and nothing amazing has happened to make it good. Average is acceptable. No news is good news as they say.

Earlier in the month I took my Dad to Vegas for a short trip. We went for a bingo event and had a really nice time. Not only did we both win some money at Bingo, but Dad also had several large wins on the slot machines and came home with pockets full of cash for the first time in nearly 10 years. Usually he doesn't have a single dollar to his name by the end of the trip. Since we both came home with money we have already booked our next Vegas trip for February. Our Christmas presents to each other were I bought the airfare and he bought tickets to go see Cher. That will be a great time. We have a blast together - he's my favorite travel companion.

Diet-wise, I feel like I am doing OK but know I could be doing better. The numbers are going down on the scale at a decent pace, but I have to admit that I am not 100% complaint. This is something I plan on fully divulging to my nurse later today at the appointment. And something I plan on taking about with the therapist when we get into that as well.

The full truth - On the weekends I kind of go wild with food and indulge in a little too much wine. I don't drink to intoxication, but the empty calories and carbs of 2-3 glasses of wine on a Friday and 2-3 glasses on a Saturday is not something I should be doing. I know this. Any diet I have been on has always had 'cheat days" and my weekends have been a free for all. I find myself pre-planning my weekend binging all week long. I eat clean during the week, have my protein shakes, track every morsel that goes in my mouth, don't go out to lunch with my coworkers, don't buy muffins and donuts in the cafeteria, but the entire week I'm thinking about how Friday after work I am going to treat myself.

This week I have bee completely obsessed with the idea of ordering Indian food. I have not have Indian food for a couple of months and have been craving it for weeks. My fat brain is justifying it by saying "You won't be able to eat this after surgery. Don't deprive yourself now." I want it SO BAD. And I am going to get it. I know it's wrong. I know it's not on plan and I'm going to eat it anyway. I'm probably not even going to feel guilty about it. My Catholic-brain tells me that this is the perfect definition of SIN, but I also know sins are forgiven when we are truly sorry. I just haven't gotten to that sorry part yet.  I'm a sinner - and it's delicious!

There have been several times in the recent months where I will pre-plan binge eating. I have never realized I was a binge eater until recently. I don't always act on these urges but I sure do think about them at a lot. For example, before going to the monthly Bariatric support group at the hospital, my fat-brain tells me that after the class I could walk 3 blocks down to the Piroshky place, or take the bus to Trader Joe's and get some treats. I did not do either of these things and instead I got a ride home where I had a normal, good meal and I was proud of myself for not giving in to temptation. But last week, after work I went to the grocery store and got a bottle of wine and a single serving of cheesecake. I ate a normal, good meal for dinner but I still had wine and cheesecake as a treat. Why did I do that? I didn't need to but I did.

Anyway, I'm not going to dwell on this. I don't sit around a beat myself up about my poor choices, but I want to acknowledge that I do see my poor choices, bad behavior, and hope to get better. That's why I'm entering therapy for food addiction and that's why I'm being honest with my doctors during this pre-surgery process. I have 4 more months before surgery. My New Year's Resolution is to learn from these mistakes and to better prepare myself for the future. Keep making good habits and priority and to lessen the food-reward system I have created for myself with the after-work wine and desserts.

I'm still going to eat that damn Indian food tonight. It's still 2016.

 

ThriftyTheresa

It's been a couple weeks since my Psych evaluation and ever since then I have been tossing around the idea of seeing a therapist/counselor . I have never entertained the idea of seeing a shrink in my life because I do not have a history of depression or other mental illness. But I also never entertained the idea of Weight Loss Surgery until this year...

After talking to the Psych at my surgical clinic I've come to realize how nice it might be to talk to someone, in depth, about my history of obesity, my relationship with food, relationships with others, and also help process my grief about the death of my mother which was directly related to her lifetime of obesity. I skimmed all of these topics with the Psych at the clinic, but overall the interview we had was about my readiness to take the step into surgery and if I was aware of what I was getting into. There's no doubt in my mind that I am ready for surgery - there was no doubt in the Psych's mind either. But the conversation clearly brought up some thoughts in my head that I have been mulling over for 2 weeks now.

I've checked my insurance and found a counseling service nearby that is not affiliated with the hospital and have sent them an "application" to find me someone to talk to. I decided to try this place instead of talking to the other psychs at my weight loss clinic because I want to do this mental health work as a separate thing to the physical work I am doing for surgery and doing them at two different clinics just makes more sense to me.

I like to think I have a support system in place, friends and family, to help me through rough times but I'm warming to the idea of speaking to a third-party who is not going to be an enabler or worry about hurt my feelings. Friends and family mean well but they're not professionals.

So...that's the nuts and bolts of it. Hopefully in the next few days I can have a meeting with someone at the counseling center and see if I will feel comfortable talking to them.

ThriftyTheresa

Officially finished my first of six months Medically Supervised Weight Loss. I was up 1 pound from the week before and will blame that on Stove Top Stuffing which is my Thanksgiving downfall. Me and the nurse went over my last month of food that I have been logging on MyFitnessPal. Her notes to me are that I am focusing too much on calorie restriction and I need to focus on high protein, low carb. I thought I was doing OK but she pointed out a few things that are probably preventing me from losing more on my own. She told me to stop thinking about calories completely - read labels starting with protein and carbs. Don't worry about high fat. Most high-protein foods have high fat but it's not all bad fat. Don't even look at fat. Try to achieve 100g-150g of protein every day. I have been getting under 100g, but usually between 80-90g each day. Try to stay below 100g carbs. This is the same info that the dietician gave me last month but I guess my mind really got caught up with calories so I was under-valuing my intake and not boosting it up with high enough protein. I need to eat more vegetables too. That's a no-duh. I hate most vegetables.

She also said I am eating too much tuna. She said to have no more than 3 servings of tuna a week. Mercury poisoning is a real thing  - LOL! I never really thought about that!

Overall I am pleased with my progress for this first month of doing it on my own. Using the info she gave me I hope that month #2 will be easier and I have my fingers crossed for a higher weight loss this month. But most of all, I want to get these new eating habits to stick and prove to them I will be a good candidate for the surgery.

ThriftyTheresa

I work in a 24/7/365 department and I had to work today - Thanksgiving day. I'm not too upset about it because it's the first time in about 4 years I've had to work today. I'm thankful for having a job and I am thankful for the health insurance that will be funding my bariatric surgery next year when the time comes.

Today I came to work prepared with a decent meal for lunch and snacks. The sugar free black cherry jello is a decent substitution for cranberry sauce. The apple slices are a decent substitution for apple pie. The frozen meal is pretty tasty and not overboard on the carbs. I'm still pre-op so I can enjoy this for now. Tonight I'll have a protein shake for dinner. Friday after work I will be cooking a small turkey breast with some veggies and potatoes for me and my Dad to celebrate Thanksgiving. Next Thanksgiving's meal is going to look a lot different than this year.

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ThriftyTheresa

Ticking off another box toward the goal! Friday Nov 18 I had my psychiatric consultation.

I was not nervous about this, maybe I should have been, but it was a walk in the park. We mostly talked about why I wanted surgery and how I am learning as much as I can about my post-op life before I get there. She briefly talked about my family and my childhood. Nothing bad there. I don't have a history of substance abuse, or eating disorders (other than overeating) and no history of depression or mental illness. I'm grateful that I don't have the struggles that so many other people have. I'm just fat, lazy, and eat a lot, mostly when I'm bored.

I probably came off sounding like a complete know-it-all, which is probably a red flag for something, but the Psych lady told me several times she was very impressed with my knowledge and said that she sees no concern for me since I am preparing myself so well. I still have 5 more months of supervised weight loss to continue to educate myself and learn more and she was very enthusiastic that I will be a successful patient.

I will get to see her one more time before surgery. We made an appointment for March which will be my Month 5 and closer to surgery time. She just wants to check in with me and see how I'm doing on this long road. Right now I'm super excited, ultra motivated, and raring to go. 5 months down the road I hope I can say the same, but if I'm starting to struggle it will be nice to have another opportunity to talk to her if I am encountering any stressors or concerns.

Next Tuesday, Nov 29th, is my official Month 1 weigh-in. I had a very good weigh-in before the Psych appointment, but I'm not counting my chickens yet. Waiting for next week to have my official results. I will update more then. Until that time - Happy Thanksgiving to all!

ThriftyTheresa

BP down 10 points!

Had a quick check-in with my primary care doctor yesterday after work. So far I've only lost about 10lbs since I started this whole shebang in September but I have a week and a half before my official MSWL weigh-in so I'm hopeful for a little more off by then. But the good news is that my high blood pressure has gone down 10 points! It's still on the high end of the scale, but it's showing progress and I am very happy about that. Doctor was glad about that too. She praised me for the work I am doing on my diet and is very happy that I am taking the steps toward weight loss surgery. She signed my "Letter of Necessity" for the surgeon's office and said to check in again with her in February or March.

Tomorrow (Friday) is my Psych eval at the weight loss clinic. Not worried about this at all. I don't have any psych problems (that I am aware of) and feel confident that I understand the risks of the surgery and am prepared for the changes my life and lifestyle habits will face post-op. Let's hope that my next update will not be "I got denied by the Psych!"

ThriftyTheresa

Saturday morning I went to the monthly support group meeting at Swedish. It's the 2nd Saturday of every month and I am already looking forward to next month!

The group was comprised of both pre-op and post-op people. Some have been post op for just a few weeks and other have been post-op for a few years. A couple people were still waiting for their surgery dates and I was probably the newest person who still has a long wait ahead of them while I go through the MSWL.

The class was hosted by one of the dieticians and we had a guest speaker from the physical therapy group of the hospital to talk to us about exercise. We went over some basic stretching exercises and she gave us elastic workout bands for strength training to use at home. Dr. Sung was also there, but he was not conducting the class. He was just hanging out with all of us and answered a few technical questions for us. He is so funny and so passionate about his job. He impresses me more every time I get to talk to him. The fact that he wants to be there for his patients on a Saturday morning when he could be having a day off speaks volumes to his dedication. It was cool to see Dr. Sung right there with us using the exercise bands and getting in a good stretch.

After the exercise class we just did a round table discussion of anything and everything that people wanted to ask or share. It was fantastic having such a variety of patients there to learn from. One of the pre-op ladies asked how people made their decision between RNY and Sleeve and we got some answers from a few people. There was a gal who just had her sleeve surgery 2 weeks ago and she was super happy and feeling great. Very encouraging for us pre-op people who many be nervous. We talked about preparing for holiday food time and also talked about being prepared with food, snacks, and protein when you travel. I have a short trip coming up next month so that was helpful for me to think in advance of bringing some healthy foods with me, especially for the plane ride.

I have a basic checkup with my Primary doctor on Wednesday to see how my blood pressure is doing. And Friday I have my Psychiatric consult at the weight loss clinic. 2 weeks until my first 1-month weight check-in. Gotta keep rocking and rolling toward the goal.

ThriftyTheresa

Yesterday was Halloween. I did not buy any candy. We only had 1 knock on our door last year so I did not buy any candy this year. Not bothered by that in the least. I wasn't craving candy, I normally don't crave candy anyway, until November 1st with all the Facebook posts about freaking candy! People posting piles and piles of candy their kids picked up, or bags of candy they have left over from trick-or-treaters. Even people in the weight loss support groups are posting tons of pictures of candy and bragging about how they are not going to eat it. I wasn't triggered to want any candy until I saw all these stupid pictures of candy! And here I am eating my sliced apple pieces.

I am also being triggered into irritation and aggravation recently by fellow pre-op and post-op people in some of these forums and groups that I read - mostly on Facebook. I get so irritated by people who aren't educating themselves about this major life-altering surgery and then doing things to put their health in jeopardy. Asking basic knowledge questions that common sense should already give you the answer. For example, "I've never experienced dumping syndrome. Is it OK to eat this Halloween candy?"  I need to step back from reading these groups or I am going to lose my mind. I have another 6 months before my own surgery and I am taking every moment to read and learn about this procedure, but I want to bang my head against my desk with some of the things I read.

On Friday I actually came here to write a huge blog post about all the bad information I keep reading and the stupid questions people are asking and the disgusting bickering and jealousies I am seeing. I wrote out that blog post and it was LONG and full of swear words that this website filters out anyway. After writing it I felt better and I did not post it, but I still feel the same way.

So I'm going to step back for a little while. Read a little less group stuff, scroll past the of the "DUH!" questions and stick to the uplifting before/after pictures and NSV moments to concentrate on the positive. I'm going to eat my apple, drink my protein shake, log my food journal, add some extra steps to my fitbit, and try to ignore the ignorant folks who are making this journey less enjoyable.

ThriftyTheresa

First appointment with the dietician at Swedish yesterday. Overall, it was OK. We talked about both my lifetime habits of bad eating and the steps I've taken over the past 2 months to try and make better choices. A lot of it is basic knowledge. Eat this/not that. Counting calories and all that business. We discussed that during this next 6 months I should try to eat a diet close to what I will be eating post-op, with a focus on protein first, vegetables second, and keeping carbs in check. She gave me a goal of 1200-1500 calories per day, 130-150g of protein, and less than 100g carbs per day. Those numbers will change post-op of course, but these were the numbers they want me to following during my 6 month supervision.

I have 3 months to do this on my own and see a nurse monthly for check-ins. Then I see the dietician again to discuss more post-op information, and then another 2 months with the nurse.

One thing they didn't give me is a weight goal. They did not say that they want me to lose X amount of weight. They did say don't gain any more weight during this time. I weighed in at 339 and can't go over that, which is fine by me. We also did not discuss exercise at all. Just food. Track my food. Eat good food. Don't eat bad food.

My biggest hurdle is pre-planning my food. I've already been tracking my food for over a month, good and bad, and the calories add up faster when I don't plan what I'm eating in advance. I'm also better on the weekdays because during the week I am partially pre-planning and at least bringing my breakfasts and snacks to work, but during the week I tend to be a meal-skipper and either don't eat lunch or don't eat dinner. Again, because I haven't pre-planned it. And then the weekends have become a free for all where I just graze or succumb to temptations.

I've done this before. Hundreds of times. Recommitting myself to healthy eating, tracking every morsel that goes in my mouth, choosing good things and not bad things, eating 5 or 6 small meals instead of 3 large meals, reading nutrition labels, drinking water, taking vitamins. None of this is new. That's both a blessing and a curse. I know how to do this. I know I can do this. But I also know I have failed at this hundreds of times too. Is this the time when the good habits will stick? I sure hope so.

ThriftyTheresa

Even though I am usually the largest person in the room, I am often completely invisible. I think a lot of fat people experience this. I've gotten used to flipping back and forth from being the person that everyone stares at to being completely ignored.

Today I was rudely reminded of this unwanted power of invisibility when I was in the cafeteria at my workplace. Typically I only get the self-serve coffee but today the yogurt I had for breakfast wasn't cutting it and I was really craving some eggs. I stood in the line at the grill and waited my turn. When I am at the front of the line, the cook looks AROUND ME like I am an obstacle and asks the guy behind me for his order. The guy behind me starts giving his order, and I pipe up and say "I WOULD LIKE SOMETHING AS WELL, PLEASE." They both look at me like I have just committed a crime. Once the stunned looks wore off the cook takes my order and I go pay for it. Scrambled eggs with mushroom and spinach. Thanks.

Somehow I became the rude person in this scenario. I waited patiently for the 5 people in front of me to get their orders and then it was my turn. And when I was being skipped over and had the balls to speak up for myself suddenly I'M the one who did something wrong, out of turn, out of line, and how dare I?

Things like this don't happen often, but they happen often enough that it's not shocking to me anymore. If I had a nickel for every time someone slammed into me on the sidewalk,  I'd have a full time chauffeured town car by now. How can you NOT see me? I'm HUGE! I'm coming right toward you! I'm moving away from you and you still manage to hit me like a bumper car! And you give ME a disgusting look like I hit YOU? Is my gravitational pull that strong?

I was reading something in a group earlier where someone said that now they have lost 1/2 of their weight they are not longer invisible and it is uncomfortable for them. The woman said she was getting a lot of unwanted male attention and she wished to be invisible again. That's a heartbreaking situation. I hope she can become more confident in herself. But for me, I don't find comfort in invisibility.

I wonder how my feelings will change once my body changes. I wonder about how people will treat me once I am no longer the biggest person in the room. Will the attention I receive be uncomfortable or unwanted? Will I wish to become invisible again? Alternately, will I become a self-absorbed, attention seeker constantly posting selfies to get admiration and praise? I don't want to be any of these scenarios.

I hope after WLS I will just be me - visible and acknowledged by those around me. I also secretly hope the cafeteria cook looks around me and skips me again because I am too skinny and he didn't see me there. :P

ThriftyTheresa

I had an embarrassing moment occur when I had my first appointment at the clinic on Wednesday. I've been thinking about it ever since and realize that it was a profound lesson to learn from.

The first nurse brought me in to a very small room to do my basic vitals. She asked me to take my shoes and socks off to be measured for height and weighed. I still have my wounded ankle wrapped in ace bandages for stability and she needed me to take that off too so the bottom of my feet would make contact with the metal conductors on the weight scale. After limping through the height measurement and standing still (very hard on a painful ankle) on the scale she said I could put my shoes back on. I normally sit on my bed or couch at home in order to wrap my ankle. I was struggling really hard to try and wrap my ankle sitting in this chair in the tiny room. There was also a blood pressure machine sitting directly in front of me that I kept bumping into with my foot or my leg. No position I tried to sit in would make it possible for me to bend over and reach my feet with both hands to get the bandage going. My big belly was in the way and I couldn't reach my feet. I was getting really frustrated.

The nurse noticed I was having a hard time and offered to help me. As soon as she asked if I needed help I started crying. It was a spontaneous panic attack. Tears running down my face, lump in my throat, nose sniffling, I can feel my chest tightening and my heart beating faster, and face growing red and warm. I kept apologizing and thanking her. I'm sorry. Thank you. Thank you so much. I am so sorry. She just kept saying It's OK. No problem. It's OK. I'm getting emotional now just remembering the scene and typing it out.

Besides the anxiety I was overwhelmed with embarrassment. This little lady had to kneel on the floor, put gloves on to touch my ace bandage with all the dead skin dandruff falling off of it, and wrap up my foot and ankle. I was mortified.

I've always been blessed to be able-bodied. Even though I am over 300lbs, I am tall and I have always been very capable of taking care of myself. Reaching my feet has always been a little hard but I can still manage to cut my toenails and even paint them from time to time. I think I'm pretty active in my day-to-day life. I've always been able to walk anywhere I need to go. I live in the city, don't drive, and I really do walk just about everywhere. I really can't imagine how much more I would weigh if I wasn't as mobile or had pain problems like I have been having with this sprained ankle.

All my life I have been self-sufficient, independent and strong. But with that little lady on the floor wrapping my foot I felt like a huge failure. I could not take care of myself and that scared the hell out of me. It was so embarrassed. More embarrassed then when I actually fell and hurt myself. In the days since I have thought about this and realized I had some smaller feelings of embarrassment when my Dad stayed with me for 3 days to help me after I fell. He brought me the crutches so I could get around. He brought me food, went to the grocery store for me, did my laundry, and even cleaned out my cat's littler box because I couldn't walk or stand to do these basic things. There were moments I teared up a little bit when he was with me, but I didn't break down. He's my Dad. He took care of me. That's what parents should do. But this little nurse, this stranger, it was devastating to have her help me.

I know where all this embarrassment comes from. Besides feeling strong and independent, I always wanted to be able to take care of myself because my own mother couldn't take care of herself. My mom died in 2010 of kidney failure brought on by uncontrolled diabetes and super morbid obesity. The last 5 years of her life were horrible. Not only were her kidney's failing but she also broke a bone in her leg. Because of the diabetes the break would not heal properly and walking was pretty much out of the picture. She was in and out of "rehab" nursing homes. My Dad did EVERYTHING for her. She barely moved a muscle. She would be in her bed or chair and just tell him to go do things for her. I never really saw her try to get better. She had really given up. My relationship with my mom soured in the last few years of her life because she was a living example of what I did not want to be and I was frustrated with her beyond belief. Nothing I could say or do was going to motivate her to change. I imagine she had times of embarrassment when she was completely immobile and unable to do anything for herself. Could not clean herself. Could not use the bathroom. But, honestly, I saw her more as a dictator on a throne ordering people around to do things for her. It's a terrible picture of my mother that I carry around with me. I wish my memories of her could be better, but it is what it is.

So right now I am fighting the fight with obesity that my mom could not fight on her own. I refuse to be immobile. I refuse to give up. I refuse to let the fat win. I refuse to die young. I refuse to stop fighting. I am strong and I know I will beat this. I just need a little help - but asking for help and accepting help is the hardest part.

ThriftyTheresa

Had my first appointment at Swedish Weight Loss Clinic yesterday. I finally feel like I have a game plan together and that the ball is OFFICIALLY rolling now. I was hoping that I would be nearly 2 months in to my supervised weight loss with the work I have been doing with my primary care doctor, but after speaking to my Nurse/Case Worker with Swedish we both came to the conclusion that it is in my best interest - as far as insurance approval goes - to do the 6 months entirely with the team at Swedish. That way there is no question from my insurance that I did a fully supervised diet with a registered dietician and doctors monitoring the whole shebang. All my monthly appointments are now planned with the first appointment being October 24th.

Sooooo...that means my last appointment will be March 29th and they will be able to submit all my paperwork to insurance in April. I could have the surgery in late April or May. Great plan!

During my appointment Wednesday I got weighed - lost 5 lbs since September. I got an EKG. They didn't talk to me about the results so I don't know anything about that. I imagine if they saw anything weird they would have told me about it.  I met with the Surgeon, Dr. Brian Sung who did the seminar the week before. He remembered me asking the tough questions - LOL - and said I have educated myself very well and he was very happy with me taking the initiative. I also met with the PA Margeaux who will be part of my surgical team. Between the 3 of us we have clearly decided upon RNY as the procedure that will be of most benefit to me. My assigned nurse/case worker will be Marcey and she was super helpful with planning everything I need to do step by step.

I will not need to do an Endoscopy because I do not have a history of acid reflux. I will not need to do a sleep study because I do not have concerns or show signs of sleep apnea. Other than my supervised weight loss and meeting with the dietician, I only have to meet with the psychologist.

I finally feel at peace knowing that the plan is 100% together. I have appointments already pre-booked for the next 6 months and know surgery will soon follow after that. I'm very excited for what the future holds!

ThriftyTheresa

I knew from the beginning that it is not going to be easy breezy coordinating everything I need to do in order to get my insurance to approve this surgery. Right now I feel like I am talking to 5 different health care people and, of course, none of them talk to each other. I am my own advocate and I am making things happen, but getting conflicting information from various sources is overwhelming,. It's making me feel like my feet are running underneath me but I am going nowhere like a cartoon character.

I have United Healthcare/Optum and to start this journey I had to contact their in-house Bariatric Services hotline first. Did that on September 10th. September 12th I got assigned a Case Manager who went over all the obligations I need to fulfill. The most complicated part has been who I need to contact for my 6-month supervised weight loss.

Case manager gave me a phone number to call that is part of the Optum program to work with a Wellness Coach. She said working with the Wellness Coach would fulfill my 6-month requirement. So I called that number on September 16th. That phone call was a huge waste of time. I gave him my health info, made a goal, and he told me to eat breakfast every day (because I normally skip it) and made an appointment to call me again in 3 weeks on October 6th. So yesterday I get a phone call from a different guy who asked me all the same questions as the first guy. Once he finally read my file which said I am a Bariatric patient he realized that I am basically talking to the wrong department. He helped get me referred to a Dietician specialist and I get to wait another 2 weeks to get that phone call on October 20th.

NOW I just got a call from the Coordinator at Swedish who processed my paperwork that I provided at the Surgical seminar on Wednesday. She says that I need to talk to THEIR Dietician but it's not covered by insurance and I will have to pay out of pocket $230 for one appointment. I don't have to do 6-months with them, but I do have to have the one appointment because it's specific education about before and after surgery.

So I have a call in to my Insurance Case Manager to get back to me about WHO should I really be talking to for this 6-month supervised weight loss. I am seeing my doctor every month (I have had 2 appointments with her in the past 2 months already) - is this medically supervised enough? Do I need to do the phone calls with the Dietician through the insurance company as well? Do I need to see the Dietician at the surgery center also and pay out of pocket? Should I just go to Weight Watchers for 6 months and get it over with (this is approved by the insurance but I'd still pay out of pocket)? All of the above? How many people want to monitor my weight for 6 months? When does this 6-month period start? Am I already in month 2, or do I need to start all over again with someone/something new?

In a perfect world I am hoping my Case Manager says to just stick with my doctor since I'm seeing her every month. That is the easiest way for me and I have physical documentation that my doctor signs every appointment so there is no question that I have been medically supervised.

SIGH! We shall see...