Day 1 - Pre-Op Liquid Diet + Measurements #2

Today is my 37th birthday.  It is also a sort of "re-birth" as today was the first day of my pre-op liquid diet that I will be on for 14 days leading to my surgery.

To mark this date appropriately, Rich helped me take my measurements again.  Interestingly enough, I gained in some areas, stayed the same in others.  I cannot believe my calves are 20" now.  I need to lose at least 6 inches to be able to get some hot boots.  I digress!

I AM APPROVED!

Today at 11:11 AM I missed a call from Nurse Jennifer.  Her voice mail made my day.

"Hey Jamie, it's Jennifer at the bariatric center.  I was calling to see when you want to get your surgery scheduled. I got the approval, so call me back!"

Music to my ears.

I gave her a call back and my surgery is set for Monday, 16 June at 7:30 AM.

So.

Happy.

I have to attend a pre-op appointment on 6 June for two hours.  I think this is the part where they go over everything to expect before/during/after surgery and to provide an opportunity to ask more questions?  We shall see!

The morning of my surgery I have to be there at 5:30 AM.  I'm not going to be able to sleep that night anyway, so that probably won't be an issue getting up at 4 AM to wash my hair and straight iron it (heh heh).  Besides, I will probably be sleeping most of that day anyhow!  If I'm not taking a walk up and down the hallway or to the restroom, I plan on catching up on my beauty sleep!

So I owe Amber some of my chocolate chip toffee cookies.  I will bring them for her on the 6th.  Small price to pay to expedite my paperwork.  I can't believe it only took 5 business days (Monday holiday doesn't count!).  I don't know what I was worried about -- thinking I'd be denied and have to make an appeal -- I did everything by the book though!

I start my liquid diet on June 2.  I really don't think I'm going to have any problem complying.  Honestly, I've had enough "last" meals the last few months.  I am ready to do whatever it takes to be SUCCESSFUL.

Oh, I forgot.  While I was at work today I instant messaged my brother and let him know the news.  He asked me if I had heard of some guy on MasterChef that had lost 155 lbs. since the show last year.  Apparently he was 400 lbs. and shocked viewers by his weight loss.  He had a sleeve gastrectomy.  He sent me an article about it which led me to a doctor's blog about WLS.  Thought I'd share a link to a very interesting article about how weight loss surgery resets the bodyweight set-point.

Waiting Game

Today marks one week since my paperwork was sent to Carefirst for review and approval.  I hadn't heard anything all week, so just because, I decided to call Carefirst myself.

I thought it would make me feel better to hear that they had received the paperwork at the very least.  I spoke to Shanika, gave her my ID, confirmed my birthdate and gave her my call back number.  She brought up my record of sorts and told me that nothing had been received.  I asked her if a week's time was sufficient to show up to where she could see the request and she said it was and that it normally shows in 24-48 hours.  So I politely thanked her and wished her a nice weekend and disconnected.

Then I furiously dialed the number for the bariatric office and chose the option to speak to the insurance specialist, Amber.  She did not answer so I left her a desperate email telling her what I had found and asked her to check into it and call me back.

Next I stewed in my chair.

Then I pulled out my medical card and flipped it over to study the numbers more closely.  Hmm.  There was a separate phone number for "Inpatient Pre-Certification".  Well THAT sounded more promising.  And I'm just the kind of person that has to be told TWICE before I believe something like my fax never arrived.

So I dialed.  I hit the option that led me to "my nurse"....A lady answered, I gave her my ID, confirmed my birthdate and gave her my call back number.  I asked her if she showed any documents received for me and she paused...typed...paused...then she said.... wait for it... wait for it....

"Is this in regards to your June 16th surgery?"  I was like OMG OMG OMG OMG (inside).  Then I was cool, calm, collected...and responded, "Yes, yes it is."....then she said...."well....TENTATIVE date for June 16th".....  :D

She said it had been received on Friday of last week and that it was still under review.  I asked if it would be OK to call back next week for a status update (as if I need permission -- HA!) and she said, "Oh yes, that will be fine -- in fact, take down this reference number and provide it when you call back so that they can find your case faster."  (Inside I said "I LOVE YOU NURSE LADY")

So I am pretty excited about having a TENTATIVE date.  I am really hoping I'll hear about approval next week.

After I got off the phone with nice Nurse Lady, I immediately called back the bariatric office insurance lady and said "oops never mind, they got it!  LOL.

Next, I looked up at my calendar and started doing calendar math in my head.  Let's see....Monday, June 16th minus 14 days on a pre-op liquid diet brings me to.......to......to.....

Um.

June 2nd.

My 37th birthday.

Which means.  I have.  Basically.  ONE WEEK.  To eat my heart out! OMG OMG OMG

Ok I actually don't mind that I'm down to one week (technically 9 days).  I have kind of over done it for the last 6 months with eating my heart out.  I am ready for the change honestly, but I will still allow myself one or two (or three) "last meals"....Rich and I already made reservations at Melting Pot for Sunday night (All You Can Eat Fondue, no less).  I may have to get some McDonald's fries (super damn fresh, of course -- otherwise, they're not worth eating).  Hmm what else.  I may need to have a slice from Sky's Pizza Pie.  That should do it.  Oh and maybe a large sweet tea from Chick-Fil-A or McD's.  That'll do.  Wait, I forgot about Reese's Cups.  And pop secret popcorn with peanut M&Ms.

So that was my excitement for today!  Yay!!!

JUNE 16TH!!!!!!!!!!!!!!!!
(maybe!)  

Nutrition One-Hour Wrap-Up

Friday morning was my one hour wrap up with Ashton.  I weighed in beforehand at 249.0.  Half a pound less than the day before.

Ashton went over in more detail each phase of my eating plan before and after surgery.  Here they are in a nutshell:

Phase 1
This comprises my pre-op diet which could be up to 14 days before surgery.  I can only have clear liquids plus protein shakes.  Clear liquids include sugar-free jell-o pudding, sugar-free popsicles, broth, crystal light, Powerade Zero.  The protein shakes are what's going to keep me full and the popsicles and pudding is what'll keep me sane LOL.

Day of Surgery
= NPO.  NPO means "nothing by mouth"...no ice chips, no gum, no NOTHING.

Post Op Day 1 is also NPO until I have my UGI which is a procedure that checks for leaks -- I believe it is the same procedure I had a little while ago when I drank some barium mixture so they can take pictures of my stomach.  As long as this is clear, then I can have clear liquid after.

Post Op Day 2 is when I begin Phase 2.  Phase 2 lasts up to 10 days until I follow up for the first time with my surgeon, Dr. G.  When I'm on Phase 2, I'm supposed to "eat" 3-5 times a day with at least two of those meals being "food" meals vs. protein shakes.  On this phase I can have watered down juices, broths, cream of wheat when cooked with lots of water or milk, milk, yogurt, and protein shakes.  I have to try to get in 80 grams of protein a day.

Phase 3 - Puree Diet
Well this should be interesting.  I'll be on the puree phase for days 10-30, approximately.  Ashton suggested mixing tuna with a bit of olive oil mayo in my Magic Bullet as a meal.  I'll only be eating 1-2 ounces at a time for each meal and my meals should last 20-30 minutes each with about 5 minutes in between each bite.  I can have all the stuff from Phases 1 and 2 plus pureed cooked eggs, high protein meats (pureed in the bullet!), smooth peanut butter (yay!!!!!), cereals like cream of wheat, melted cheese (double yay!), fat free cottage cheese, skim milk, mashed potatoes, pureed/mashed green beans, canned fruits (awesome), baby foods (NOT).  Things I can have but in moderation (once a day I think) are sf pudding, sf gelatin, low sugar or sugar free ice cream or yogurt, salt, mayo, butter, sour cream, herbs & spices.  This will be a fun phase I think!

Phase 4 - Soft Diet
I'll transition into Phase 4 at about the 30 day mark and be on it for approximately 4 weeks.  At week 6 post-op I'll meet with my surgeon again for follow up.  Again I'll be eating 3-5 times a day but only about 1-2 ounces per meal.  This phase basically includes any non-irritating low residue foods.  Everything I eat has to be thoroughly chewed to avoid obstructions or blockage.  I can only add in one new food to each meal so if I have an adverse reaction I will know what did it.  Protein will be the "star" of each meal and what I eat FIRST.  The foods I'll be allowed will include everything from Phases 1-3 plus low fiber cereals such as cheerios, rice krispies, or special K.  At this stage I won't have to puree anything but I just have to chew, chew, chew!  I have a feeling I will be eating a lot of eggs, cheese, yogurt, peanut butter, and chicken here.  I am going to change things up though and make some flakey fish here and there and have thin deli meats for lunches.

Phase 5 - Regular Diet
This will start at around Week 8 which will be mid- to late-August I think.  Initially, I can have all foods except those that cannot be thoroughly chewed or which cause discomfort or irritation.  I have to avoid bread, rice and pasta for SIX MONTHS after surgery and avoid solid red meat until I get my surgeon's OK.  I am supposed to have 2 cups of milk or yogurt daily and a protein supplement that provides at least 20 grams of protein.  A sample breakfast is 2 tbsp of eggs and 2 tbsp of oatmeal.  A snack would be 1 oz of cheese and 1-2 slices of apple or 1 ounce of chicken salad and a couple of whole grain crackers.  It's hard to believe that will fill me up, but I bet you it will!

Eventually on Phase 5 over time I'll be able to eat slightly more at each meal.  When this happens, my regular diet will consist of three small meals per day limited in volume to 3-4 ounces per meal.  I have to remember to listen to my body and stop at the first signs of fullness.  I have read on my Facebook groups that some people's first "signs" are hiccups, burping, or just an uncomfortable sensation.  That's why you have to space out your bites of food and take your time so that you don't eat too much and your body has time to TELL you it's full.  A typical breakfast for me on this second part of the Phase 5 diet would be 2 oz of high protein greek yogurt and 2 oz of Kashi Go Lean cereal. A snack might be a slice of cheese if I really felt I needed something between meals or there is a long time between meals, but I have to limit my snacks to 1-2 ounces.

So that's about it for my wrap up appointment.  Afterwards I went back to the front desk for Ashton and I to talk to Amber the insurance girl.  Ashton asked if they could submit to my insurance without cardiac clearance and Amber said they could, yes, since it isn't the insurance that requires the cardiac clearance, it's my doc, so we can get that later if need be.  While we were standing there, Nurse Jenn comes out and says she just got a call from the cardiac office and they said they didn't receive the results yet.

I decided to go up there to see what could be done to expedite things.  I was firm but nice and they told me that most likely my results were in "transcription" which is where they go to be written up for the doctor to interpret.  Ashton assured me when I went back down to report on my findings that she would keep on top of things.  When we asked Amber about submitting that day I told her there would be cupcakes in it for her...then Ashton mentioned to Amber that I was the "cookie lady" and Amber's whole face lit up!  She said she LOVED my cookies and she'd rather have those than cupcakes any day.  I told her you got it!  So I have some baking to do before my next appointment LOL.

This afternoon as I was reviewing the eating plan for this blog, I came across Amber's email address, so I sent an email to her and to Ashton asking if they were able to submit Friday.

Oh and I also got my lab work results -- I was deficient in Vitamins A and D, but being on the multi should take care of those levels.

This week is clear as far as appointments go, Thank God.  I am tired of driving around places after work, even though it is for this.

Ashton mentioned that once I get insurance approval, Jenn will call me to schedule the surgery AND my pre-op class which (again) goes over Phase 1 pre-op diet and other things.  I thought I remember her saying I'd have to have more labs before surgery too, but I honestly can't remember now.

What a whirlwind it has been and my poor leave balances at work have taken a beating.  I will be working the next few holidays to bank hours for my surgery so that I can be paid 100% of what I am used to getting.  And to ensure I have enough leave for our trip to Ireland in September.

One additional thought.  My husband and I often entertain ourselves by eating out or ordering in.  Once I have surgery, I have a feeling that eating out (in Phase 5 +) will be frustrating and a waste of money, which will totally take the fun out of it.  I hope that we can come up with new (more active) ways of spending time together like working out or taking more drives to the beach with our pups.

I am nervous about Ireland and what I'll be eating there.  I have a feeling I will be taking a bunch of protein powder with me to ensure I get 80 grams in.  At least I'll be thinner by then and feeling better.

So now that I don't have any more appointments scheduled (although I do have a PCP appt 6/4), it is now just a waiting game until insurance approval.

I have a guess as to my surgery date:  the 17th.  It's my lucky number.

Nutritionist Consult #6

Weighed in at 249.5 so lost a half pound since last month.  Then met with Ashton.  It seemed like a formality.  We didn't set any more "goals" for next month.  It was maybe a 10 minute meeting.

Here's my $35 copay, please weigh me.  Okay, okay, I know it's necessary for insurance approval.  Besides, tomorrow is my one hour meeting with Ashton to go over the whole eating plan before and after surgery -- all of the phases.

She did have my chart and she asked me when I did my labs -- I told her it was in February.  Apparently it is not uncommon that the lab people forget to send them to the bariatric office.  Plus I technically do not have cardiac clearance yet -- waiting on Dr. Langhorne to review my stress test pictures.  Ashton said she would follow up on both tomorrow.

So once she's got what she needs, she submits usually same day to insurance.  Amber, the "insurance chick" that works there said that for Carefirst Administrators, their response time "depends on how busy they are"....I asked if it helped at all if I called every day and she said no.  LOL, I tried.

Ashton did ask me if I had a date in mind for the surgery (because of work) and I said as soon as possible, but it would be nice to have it on my birthday, June 2nd.  I have also had the 17th in mind because it is my lucky number.

Honestly I told her that any date in June would make me happy, and she said she thought that would be possible as they are not scheduling very far out, meaning, they are not booked up the next couple months or anything.

So it was pretty short and sweet.  I still can't believe how fast time has flown.  I still have worries that insurance will deny me and my doc will have to appeal for me and I won't have surgery until long after June.

The journey thus far has had some bumps but I think it has been pretty darn smooth.  I sure am hoping everything works out the way I have it planned in my head.

Support Group

Rich and I attended support group tonight.  There was no special guest -- it was the nutritionist Ashton and nurse Jennifer and Dr. G (nice surprise!).

Other than Lori, there were no familiar faces from last month, including the new friend I made last month that had the sleeve - Leticia.

One new thing I learned was that those who have an issue with depression pre-surgery will have a greater likelihood of having increased depression symptom post-surgery.  One of the reasons is that the patient still sees their old (fat) self even after they've lost the weight.

I have never had a problem with depression.  Sure, I've been depressed about my weight from time to time, I've been depressed because I haven't seen my family in a while and am sad.  I may wake up in a bad mood and seem depressed all day.  But being depressed (at least to me) is different from "having depression" -- at least in the clinical sense that one is diagnosed.

See, I can't even IMAGINE that I would see my old fat self after losing weight.  Sure, I may think, "oh, I hope I can lose 15 more pounds - that would be great!".  

But I have lost weight before and I distinctly remember feeling AMAZING, CONFIDENT, SEXY, loving the attention.  It was mentioned by the doctor tonight that some people can't handle the new attention or the way people now look at them after they've lost weight.  

I sincerely hope that I am not like that.  After years and years of feeling overlooked by others because of my weight -- strangers and non-strangers alike, I would welcome the compliments.

HOWEVER.

I know I am going to be one of those people that will be very annoyed, disappointed, and/or angry because of the attention/comments/compliments/acknowledgement/etc. that I receive once I'm at a healthy weight that DIDN'T give me the time of day when I was heavier.  

So if you're going to be one of those people that says hello (and you never did before) or ask me to hang out or go for drinks (when you didn't before), or if you're going to be jealous of my success or my smaller-size-than-you jeans I rock out, please just keep it to yourself and ignore me like you did before.  My weight doesn't define me, my character does, among other important traits.  And honestly if you are one that treats ANYONE differently based on their weight (or sexual orientation, or race, or gender, or nationality, etc etc etc), then you are probably not someone I want to have in my life anyway.  :)

Ok, that is all.

Echocardiogram & Stress Test

Tuesday this week I had to get to the hospital at 8 AM for my stress test.  Once I got back there, they started an IV so that they could administer some kind of radioactive fluid that is needed to take good pictures of my heart.  I had to wait 45 minutes for the fluid to get through my body, so they went ahead and did my echo to take advantage of the downtime.

The echo chick was nice.  I had to put on a gown so that she would have access to the left side of my chest.  All she did was do a sonogram of my heart from a ton of angles.  She took about 25 minutes or so to finish.  Wasn't so bad!

Once I wiped off all the gel and got dressed, it was time for my pre-stress test photos.  I laid down on this very thin (8 inches wide) strip of metal with a pillow under my knees for comfort.  The nurse told me to put my left arm above my head and then gave me a rope to hold on to.  My right arm had the IV still in it and although it was "flexible", it was painfully uncomfortable to bend my arm and they wouldn't let me hold my arm across my waist anyway, so I had to tuck a few fingers under my butt to keep my arm still.

The photo taking machine was very close to my chest and it rotated around from left to right, stopping about a dozen times to take photos from all kinds of angles.  The whole process of pre-stress test pix took 10 minutes.

When it was done, I could move my arms and my poor right hand was completely numb.  The nurse helped me up and took me to the treadmill room.

I met two ladies -- one was in charge of the machine that controls the treadmill and also monitors my heart rate and blood pressure.  The second lady was there to watch me on the treadmill and once my heart rate got to 85% of max (which was about 156 bpm), she was to inject me with more radioactive fluid.

The treadmill started at an incline at at around 2.5 mph.  Within a couple minutes my heart rate jumped from the 90s to the 120s.  I was thinking based on that quick increase, this would be a piece of cake.

Boy was I wrong.

I hovered in the 120s for so long that they decided to bump it up -- the incline AND the speed...to 3 mph.  Eventually my heart rate went up to the upper 140s.  After another minute or two they bumped up the speed to 3.5 mph and I felt like I was at my max.  They asked me if I was OK, do I feel lightheaded, etc...and I responded, "Just trying to breathe!!"...

I couldn't walk at 3.5 mph (had to go into a jog), so they decreased it to 3.0 and I was so close to 156 bpm that they went ahead and stopped the treadmill and injected the fluid into my IV.

Then they made me sit in a chair for 10 minutes to get my heart rate down back down under 100.

After that, I was taken back to the thin metal bed and did those pictures for a 2nd time.  The goal is that both pictures "match".

Once they released me I headed home and took a 3 hour nap.  Oh by the way, I was on the treadmill for a total of 7 minutes and 6 seconds.  I am so out of shape.  In my defense, though, they didn't let me warm up or cool down, which I would've done to increase my endurance in a normal treadmill workout....and eventually build up the incline, but really they just threw me into it to make my heart beat faster quickly.

Friday morning I got a call from that office from Ann.  She informed me that I had PASSED my echo, that it was NORMAL.  She said she did not have my stress test results as Dr. Langhorne was not in the office today, but I would get them some time next week hopefully.

Next week is the BIG week.  MY big week.  Last NUT appointment, final write up....I also have support group, have to get some blood drawn for my 6 month PCP appointment.  Just LOTS to do.

Ann seemed confident that my stress test results would be fine based on my good echo.  We shall see. I am crossing my fingers.

Vitamins

So I got my first box of vitamins and Nascobal from the Q Pharmacy folks that had a rep at my first support group meeting last month.  It was a nice surprise to also get an iron supplement because they mentioned at support group that you'd need to pick that up separately since their multi did not have iron in it.  For $25 per month, you really can't find a better deal around.

I ordered a very cool vitamin/pill organizer off of Amazon and filled it up for the week and officially started them all yesterday.  I ended up ordering a 2nd container so that I only have to prep them twice a month.

I've only been taking all of them for barely two days but it'll be interesting to see if I feel any better, have more energy, etc. after I'm on them a while.

So here's a picture of what I'm all taking as far as vites.  I added the Biotin in since I already purchased a couple bottles.  It promotes new hair growth, nail growth, etc....but I've heard it promotes hair growth EVERYWHERE.  Maybe I should look for shaver coupons.

This is my cool ass pill organizer I got on Amazon here:  http://www.amazon.com/gp/product/B000E13BVA/ref=oh_details_o03_s00_i00?ie=UTF8&psc=1

EKG Results - Follow Up

Today I had a follow up EKG with Dr. Langhorne.  Dr. Langhorne has been in practice as a cardiologist for 51 years.  He was very grandfatherly -- sweet looking, experienced, gentle.  I actually really liked him after I got over the shock of his age...until he said two things to me:

1. He referred to me as having a "large frame" (TWICE)....in reference to where the EKG stickers are placed, sometimes they are not placed in the exact right places to get a proper EKG.  So basically he admitted it was a technical issue of placement that is further complicated by my fat.
2. The doc asked me if I exercise regularly. (No)  Do I have any trouble walking.  (No)  Do I have any difficulty with taking stairs.  (Not really, unless we're talking more than two flights).  He must've noticed my quizzical expression at all of the questions because he said, "you'll need to do a stress test."...oh gawd, no.  Apparently if I was incapable of walking or stairs, I could've had done the next test chemically, somehow...Damn.  I was so prideful with being able to say that I can walk and do stairs that if I had answered differently, I could remain my lazy self and skip the treadmill altogether.

So my "stress test" is seriously stressing me out -- just another appointment, more tests (he also wants an echocardiogram, which is a sonogram of my heart walls), more sick leave to take that I barely have....more missed work.  And just another hurdle to hopefully get over and get closer to a surgery date.

So all this crap is scheduled for Tuesday, 6 May.  I have to be there at 8 AM and it'll take three hours. I seriously better not be on a damn treadmill most of that time.  Then I get to eat lunch and my echo is at 12:30 PM same day.

BTW, this is Dr. Langhorne.  Hope he's alive long enough to review my results!  ROFLMAO.

I'm going to Hell.

Age 132

EKG Results

Abnormal.

Can't say I'm not worried.....but just a teeny bit.

I'll be going to another appointment soon for a 2nd EKG and if that one is still abnormal, I may have to do a stress test.

I posted on Bariatric Bad Girls Club (it's a Facebook support group) about it and apparently I should have nothing to worry about - abnormal results are common.

Of course I also Googled it right away and if you are not warm enough or still enough, it could skew the results and make them appear abnormal.

Nutritionist Consult #5

Ashton weighed me in since Nurse Jennifer is on vacation this week.  They sent away their main scale to be recalibrated (duh), so I weighed on their back up  -- a Tanita scale.  It read 250.0.  Up 2 pounds since last month.

Two hundred and fifty pounds.  An eighth of a ton.  Halfway to three hundred.  My highest adult weight.  What's funny, if anything can be "funny" about that is that I am not really that upset about it. Because I know my life is going to change very soon.

In approximately 64 days, my journey continues with a permanent, life-long tool.  A tool that if used correctly, will help me shed 50-75% of my excess weight (in my case 50-75 lbs).

Ashton and I talked about how I did on my goals last month and created new ones for this month.  We talked more in depth about vitamins.  One of my goals for this month is to work on my organizational and planning skills for meals and snacks.  Another one is to walk a mile five times a week.

My next appointment is on Thursday, May 15th after work.  The day after will be my final writeup with Ashton, an hour long appointment in the morning where she will go over more in depth about my eating plan during each phase after surgery, as well as a review of all of the good habits I have been practicing that I will need to stick to after surgery.

Ashton told me that once the paperwork is sent to the insurance company, they will take 1-10 business days to respond and hopefully APPROVE me for surgery.  Then and only then will my surgery be scheduled, and that will likely be 2-3 weeks out from the date of approval.

Somewhere between approval and surgery date I will be attending a pre-op class and meet one last time with Dr. G.  I also will have to do a 1-2 week liquid diet (gawd please be only one week).

Another piece of info Ashton confirmed is that Dr. G only does surgeries on Mondays and Tuesdays.  I don't know why but I have the expected surgery date of 6/17 in my head.  I can't explain it, but I just have a feeling.  I'm counting on it, I guess.

When I went to check out, Hope asked if I had a chest x-ray done yet.  I thought I had checked off all the boxes, but I must've missed the chest x-ray, so I got that taken care of today, too.

That is all for now.  Still can't believe how fast time flies.  I'll be on the surgery table before I know it.

That makes me very happy.

My 1st Support Group

Tonight was support group night and Rich accompanied me.  It was pretty cool.

Other than several pre- and post-op attendees, Jennifer the Nurse and Ashton my Nutritionist were there along with a guest, Ryan, who informed us about a new FDA approved B-12 nasal mist called Nascoball.

I also met a girl named Leticia who had the sleeve done two months ago.

Leticia is already 47 lbs. down.

I asked her for her number so I could keep in touch with her between meetings.  And I told her about my favorite Facebook group for bariatric support.

One of the post-op ladies, Laura, told her story.  She works at Navy Fed - I recognized her husband right away.  I found that we had a few similarities which was inspirational.

She said that every day she woke up she was tired.  She was tired all day at work and after work she just crashed on the couch and didn't want to do anything.  Now she is over 120 lbs. down (after a year) and once she decompresses for a little time after work, she's like "what can we do around the house?  lets do some gardening, run errands, etc etc"....so needless to say she has a lot of energy to do things she never felt like doing.

Pretty cool.  I'll head back next month and every month after.

Interesting!

My mom sent me my "school records" book that she kept on me from K-12th grade.

Each page in the book has a bunch of stuff to fill in each year to keep track of my growth and the opposite side of that is a space for a school picture which is also a folder that holds my report cards, awards, and anything else significant.

The reason I wanted it is because every year we recorded my height and weight.  

Tonight I looked up my stats at age 8, 11, 13, and 18 just to see if by general standards, I was in a normal range for my age/height/weight.

At age 8, I had a BMI of 16.9.

At age 11, it was 19.5.

At age 13, it was 21.5.

At age 18, it was 23.5.

At all four ages I was considered in a "healthy range".  It was interesting that it continued to increase rather than staying steady.

Why is it that I always felt chubby my entire childhood?  Even my daddy nicknamed me "Chubbs" at some point as a small girl, but I don't remember feeling bad because of that, I saw it as a term of endearment honestly.

Maybe other school kids made me feel different than everyone else and I just grew to believe it myself.  

Funny to see that when I graduated high school in 1995, I weighed around 155 lbs, which is well within my ideal range that I want to get down to.

Ugh. Feeling Fat.

It sucks carrying this much weight.  I am only a few pounds from my highest weight in my adult life.  Hell...my ENTIRE life and I am feeling every ounce of it.  My wedding rings are too tight -- I can't wear them without discomfort.  My underwear I wear the most is so uncomfortable.  I'm lucky I still have two work pants that I can wear.  I am bored with my closet.  I feel like I'm not good enough to wear all of my gorgeous heels.

I remember when I was down to 202 (Nov 2011 or so).  Feeling sexy even though I still had lots of fat.  I rocked stilettos, had a waistline, was wearing size large tops and 14 bottoms.  I looked forward to planning outfits each morning.  I took time to groom myself, took pride in my appearance.  Loved the attention from people that hadn't seen me in a while.  Then I gained it all back.  Just like the other dozen times I've tried to lose weight and keep it off.

That's why this tool -- my sleeve -- will be a godsend.  I need something to help me -- permanently...for life.   I will have to use it to my advantage -- it won't do all the work for me.  I will be committed.  I will be different.  I will eat well.  I will get all my protein in....I will drink all my water.  I will avoid carbonated drinks, alcohol, and non-nutritious foods for a very long time....I can't say I will never have an Oreo again (I will), but in the beginning, I am going to be the star pupil.  I will surprise myself.  I will be a success story.

If I have calculated correctly, at the latest, my surgery date will be about 17 June or so, and that's being generous.  That's 75 days from today.  Yes, I have a counter on my cell phone.  (I also have a counter for Cape San Blas trip - 17 days, and Ireland - 172 days).

So I am taking it day by day.  Looking forward to getting ONE more appointment behind me.  April 14th can't come fast enough.  May 15th, May 16th, waiting to hear back about insurance approval, getting a surgery date....surgery day....then....then my journey continues.  The hard part.  The best part.  The rest of my life.  Being healthier, feeling better, looking better, living fully, being happy.

That's all I want.

Sleep Study Results

I do not have sleep apnea!

Which really surprises me, actually.  So why am I tired all the time?  

I think the answer is PRETTY obvious now:

I eat nutritionally shitty food.

I don't exercise.

I'm 100 pounds overweight.

DUH

Sleep Study

My sleep study was located at Gulf Breeze Hospital on Friday night.  I had to be there by 8:30 PM and arrived early around 8.  I brought my pillow, my cuddle pillow, my Kindle, my lip medex, and my toothbrush and toothpaste.

When I got there I met Nate and Ron.  Ron was a very tall older gentleman with a deep southern drawl who had gastric bypass 3 years ago.  He said that he was once 320 pounds and lost over 100 lbs.  Nate was a very young kid -- I'm guessing around 23 or so.  I found out later that he's only been doing sleep studies since November.  He was very professional, though, and definitely knew what he was doing.

Nate brought me back to room #3, which was a modest sized room with a full sized bed, headboard, side table with a lamp, side chair, and a full bathroom.  Not what I expected!  Somehow I had in my head a more hospital-like setting with a couple people in a room above me that looked down into the room - watching me all night through a few glass panes.  Boy was I off!

Nate had me fill out a bunch of paperwork that asked me about my sleep habits, my current medications, etc.  Once I was done, he had me sit in a chair in my bedroom.  He had all kinds of wires and electrodes that he attached to my legs, my chest, my temples, and my scalp.  I also had  something attached to my middle finger.  And a couple of bands around my chest and abdomen.

Once I was all set, I got into bed and he told me I could relax, read, watch TV until I was ready to go to bed.  In a few minutes he was going to come on the speaker and ask me to do a couple of things.  I was reading a really good book, so I read for a while and then suddenly he roars on the speaker and startled the shit out of me LOL...I think he could tell I was startled (and annoyed) and he apologized and said that the guy he was helping before me was hard of hearing.  Nate asked me to wiggle my left leg, then my right.  Then I had to shut my eyes for 30 seconds.  Then open them.  Then he asked me to look up, look down, left, and right.  Then I had to hold my breath and push my belly in and out.  I supposed he was ensuring everything worked and was calibrating settings in his office.  By the way, the office had like 5 giant computer monitors that showed lots of data and brainwaves and all kinds of different things - very cool.

After he left me alone, I continued reading and got super sleepy around 10, so I turned out my bedside lamp, tried to get comfortable, and shut my eyes.

I was pretty tired, so I was surprised I didn't just pass out by then, but then not surprisingly, those damn wires were EVERYWHERE and I was extremely AWARE of them.  I was afraid of disconnecting something or ripping one of them off by accident so I really couldn't get onto my belly the way I normally sleep.  Nate said I could sleep however I wanted, but he didn't know that I am used to the left side of the bed, not the right side, so I was already screwed up from what I am used to.  Ok but back to the damn wires.  I tried my hardest to forget about them and eventually found myself drifting off to sleep.  Then the damn door opens and a bright swath of light -- seemingly from the heavens opening up into the depths of hell -- and in comes Nate.  I had disconnected the thingy on me left leg.  Ughhhhh.

Ok, I had to shut my eyes and concentrate hard on falling asleep.  Shit, I had no idea what time it was.  No clock to look at (I had shut my phone off to save the battery). How long was I going to be awake?  What if I never fall asleep and they didn't have enough data to determine if I had sleep apnea?  What if I don't fall asleep and they have to reschedule me to come in but the next appointment isn't available until September?  Then I can't have surgery in June.  FALL ASLEEP JAMIE.  I suppose I was overthinking it and not letting things happen naturally.  YOU try falling asleep fully clothed, with hair getting in your ears and tickling your neck and two dozen wires attached mainly to your head.  Oh by the way, don't forget the nasal thingies I had in so he could monitor how forceful the air was coming out of my nose.  But then it tickled my upper lip and somewhat blocked the air coming out of my nose, so I had to sleep with my mouth partially open, then my mouth got really dry.  OMG it was one thing after another.

But guess what?

I fell asleep eventually.

At 5:30 AM, Mr. Nate came in to wake me up and detach everything from me so I could get the hell out of there.  He asked me how I slept.  Fitfully.  I told him the bed was too hard, the room was too cold, there was noise outside of my room, etc., etc., etc....  After I cleaned up a bit and got my shit together, I headed out to the front office.  They were still uploading my data, but he said that although it is not his call to make a determination (it would be my doctor's call), most likely I do NOT have sleep apnea.  He said I had been dreaming.  That I only woke up about 5 times (it's bad when it's double digits).  I asked him if I snored and he said "yes, consistently all night" and that it wasn't that loud because they didn't "turn me down"....then Ron said, it was a "princess snore" which made me laugh.

So that's it.  I have my follow up sleep appointment scheduled for Wednesday, but I don't think I'll have to go -- I'll hear by then if I have to come back but I'm hoping I don't have to.

I was REALLY surprised by what Nate and Ron told me that morning because I was 99% certain that I had apnea.  But I have to admit I am seriously relieved because I honestly think I would've had trouble getting used to using a CPAP machine.

Once I have surgery I will be eating better and losing weight, which in turn will make me feel better and most certainly sleep better as well.

I'm so glad that is over with.

Now I just have 3 more appointments.  Nutritionist #5 on April 14th, Nutritionist #6 on May 15th, then my last "final writeup" nutritionist visit with Ashton on May 16th.

SO looking forward to April....I really can't believe how time flies.  AND what I'm really looking forward to is my me-cation this weekend in Biloxi and then our long weekend in Cape San Blas in just 28 days.

So many things to look forward to -- cheers to LIFE!

Nutritionist Consult #4

I seriously can't believe I just had my FOURTH appointment!  Time is flying by yet June seems so far away...

So I brought in two dozen of my "famous" chocolate chip toffee cookies to the bariatric office.  Believe me, I mentioned it last visit and thought it would be inappropriate but they said NO, please bring them, so I did!  And they loved them. LOL

Nurse Jennifer took me back for my weight.  I was heartbroken when the scale read 255.  Honestly I was in shock because that would be 12 pounds higher than last month.

When I got to Ashton's office I just broke down and started crying because honestly I thought I had maintained my weight if not lost a little.  Ashton immediately informed me that they had been having issues with the scale and one lady's weight was as much as 20 lbs. off from what she really was.  So she said if I wanted to, we could reweigh before I left.

We talked about how I did on my goals last month and I confessed that I did not do well at all which is probably why I gained 12 lbs.  I pretty much ate what I wanted to, didn't write down my food, and exercised maybe once on purpose.  So maybe I deserved to gain.  She said that journaling our food doesn't work for everyone so that made me feel better.

We focused on the topic of protein -- she said that after I start to eat real food 8 weeks out, I will need to get at least 80 grams of protein in.  So one of my goals this month is to have protein of some sort with every meal.

My other goals are to try a new healthy recipe at least once a week, have fried foods only twice a week, and to practice separating eating and drinking during breakfast since dinner didn't work out for me so well last month.

I feel more motivated to stick to my goals without the pressure of journaling my food. We'll see I guess!

Sooo it was funny that the entire time I was meeting with Ashton I noticed she couldn't stop looking up at a piece of hair that was sticking straight up from my head and I was staring at the crumb in the corner of her mouth from the cookies of mine she ate right before she came in.  ROFLMAO

Ok anywho, we went back in to the scale room.  I reweighed at 248....a half a pound less than last month!  THANK GOODNESS because I would've been really upset with myself otherwise.

That is all!

Random Thoughts

I can't wait for the day when my reflection makes me do a double take.

When my husband doesn't recognize me from behind and says, "Oh wow, I didn't realize that was you!"

When I walk in to work in a cute, flattering outfit and I am so confident that it just seeps out of my pores and makes my smile infectious.

The day that I realize I'm probably a (another) size smaller.

When I don't give a second thought to signing up for a 5K, or taking four flights of stairs to my car on the top of the parking garage.

When the first person notices my body changing drastically.

I can't wait for that day that my fat jeans fall off of me.

When I may actually need to purchase a belt to hold my pants up.  Or hell -- for FASHION reasons!

When I see my family again after a lot of weight loss and they are speechless.

When I inspire someone else to have surgery and take charge of their health.

It'll be interesting to see if more people try to be my friend or noticeably pay more attention to me because of my weight loss....AND if any of my closer pals act differently because of my weight loss....I hope not.

I look forward to fitting great in a plane seat and not feeling inadequate in a bathing suit and wearing knee high boots next fall and skirts that don't go to my ankles and realizing no matter what photo is taken of me that it's my "good" side...

I can't wait for the day when I enjoy exercising and not feeling as if I'm going to throw up afterwards.

Will there be a day I take up running?

How about a day when I purchase a pair of jeans in a single-digit size?

Will there be a day that comes when I'm satisfied with my body weight, proud of my accomplishments, and loving life even more than I ever imagined?

I hope so.

I can't wait for the rest of my life to start. It'll be a great life to live in a body I am so comfortable in.

Psych Results

I asked the psychologist if she'd share my test results.  Here they are:

These kinds of tests are normed against a sample group.  As a result, they provide interpretations based on personality styles of those who produced a similar profile to yours.

It's important to remember that some of the statements may be true for you and some may not.

• The profile indicated that you are not experiencing psychiatric distress at this time.  
• It suggested that you may tend to be a person who maintains an image of competitiveness and self-assertion. 
• You may tend to be on guard with those outside your circle of family and friends, protecting yourself by keeping a cool distance. 
• Others might better earn respect by approaching issues in a straightforward and honest manner. 
• You might benefit from being included as an active participant in planning and carrying out the treatment program. 
• You likely demonstrate appropriate concern about your health and are likely to be an accurate reporter of any changes in symptoms and functioning. 
• The profile indicated a high likelihood that the patient will maintain post surgical weight loss and avoid long term health complications. 
• The post surgery outlook was good across all domains (quality of life, body image, physical health, etc). 

So it looks like I'm in the clear!  I have my 4th nutritionist appointment scheduled for this coming Wednesday, 12 March.  After that, on 3/21 is my sleep study.  Looking forward to making additional progress and checking things off "the list"!

Endoscopy Results

Today I met with Dr. G to go over my EGD results from late January.

Nothing bad showed up but he said he did see my (small) hiatal hernia and said he'd fix it for me while he's doing my sleeve.  It should help cut down on my acid reflux in addition to eating better foods.

Before I got to Dr. G, Jennifer the Nurse took my blood pressure (normal) and weight.  I said, "you're going to weigh me while I'm here?" and she replied, "I have to weigh you every time you're here."  I had just drunk a coffee (yes, coffee -- my friend Michelle got me liking the white chocolate mochas at Starbucks and they have one in the hospital).  So I felt fat and full and bloated and of course that weighed me down.  Literally.  Since my Nutritionist #3 appointment on February 10th, I gained another three pounds.  Geez!

But what do I expect.  I've been eating whatever I want and not walking.  My next appointment with Ashton the Nutritionist is on March 12th, so I have about two weeks to try and lose a few pounds (which would make me feel less guilty).

I know I don't have to, but I want to.  And to start in the right direction, I skipped my evening snack tonight.  There.

Psych!

Today was my psychological evaluation.  I had some butterflies beforehand, but enjoyed it more than I'd imagined!  My dumb ass forgot all the paperwork I had filled out in advance, so I had to do it all over again  Oh well, good thing I was early.

Once I got back with the doctor, she set me up on a computer to answer about 170 true or false questions.  I love filling shit out, so I was all over this!  Some of the questions were interesting, all were only a sentence long, and some were thrown in to make sure you were paying attention.  I answered truthfully and for the most part, swiftly, however, there were a few that I had to think hard about which way I leaned more on the answer.

Once I was done with the computer test, there were a couple other tests that asked me how I had been feeling for the last one or two weeks, respectively.

After I completed all of the testing, which took approximately 20-30 minutes, I met with the doctor in her office.  She asked me a bunch of questions.  We talked about why I chose the vertical sleeve gastrectomy over gastric bypass.  She asked me about my support system, about what changes I was making in advance of the surgery and checked my understanding of the life changes that will occur after surgery.

So that was that.  Not as intimidating as I thought!

Upper GI & Chest Images

Yesterday I got to check off two more items from my long to do list.

I started with the chest x-rays.  I just had to lift my shirt up and she put some warm jelly on my abdomen.  She made me hold my breath a few times for 10-20 seconds at a time and move on my sides so she could get images captured of my kidney, spleen, gall bladder, liver etc.

Then I had the upper GI series.  For this I had to get into a gown and do shots of powder alka seltzer with a chaser of water.  :)  Once I did that to avoid upset stomach, I had to drink about 5 large sips/gulps of a barium sulfate compound which didn't taste as bad as I thought it would.  It was a bit chalky.  The two men that did the pictures made me turn over a couple times on the bed -- a full 360 degrees, so that the barium fully coated all sides of my stomach.

When I left I was advised to drink 6 to 8 glasses of water to flush out the barium and that my poop would be white/chalky for the next few days.

Later on in the afternoon around 3 PM I thought I had to pee really bad, so bad it hurt, but after I relieved myself, the pain still subsided for much of the evening.  I think it was just mild cramps related to the barium, but apparently cramps are a rare side effect.

I was fine this morning.

Blood Panel + EKG and PAP!

So today I got a few things accomplished and "checked" off my list of things to do before I can have surgery.

This morning I went down to Baptist and got my blood drawn plus had an EKG which took all of 10 seconds or so.  I loved the guy that drew my blood, Teddy G.  I asked him if his last name was Graham.  Hehe.  He got it on the first try and the EKG took longer to set up than the test took once it was ready to go.

After I was done I went over to see Hope in the Bariatric office to get my next three appointments changed.  I counted the days between my February and March appointments and it was only 27 days in between.  From what I have read online and even Hope had mentioned before that the insurance likes to see 30 days in between appointment dates. 

Later this afternoon I went over to West Florida to Dr. Mehta for my annual PAP.  I really like him so much.  He makes me feel at ease and doesn't mind dumb/weird questions.  He is awesome.  Although they took me back in a reasonable amount of time after my 1:45 appointment time, I waited in the room for almost 30 minutes.  Kind of annoying, but oh well.  I was on my own time.

I can't keep thinking about all the changes to my life, my health, my WARDROBE.  :D  I have certain shirts that are going to fit me for a while as I lose, and then I expect them to look ridiculous on me.  Once I get to my "goal weight" (whatever that is), I'm going to buy some expensive Miss Me jeans because I love the back pocket designs and want to draw attention to my rear!  Just kidding.  Psych!  Anyhow, every time I go out shopping -- we went to the outlet stores in Foley this weekend -- I have to tell myself NOT to buy any clothes because it will be a waste of money.  I really want to start visiting thrift stores to start building my wardrobe up at smaller sizes, but it makes more sense to do that when I can actually try things on instead of assuming a certain size of ANYTHING is going to look perfect on me.  I am having trouble holding back.

I did recently order a sample pack of protein shake mixes from Unjury, which is the sample I got from my nutritionist.  I liked the vanilla flavor, so now I'll be able to try a few others.  I am also going to order a 64 oz container that will hold the water I need to drink everyday and I'm going to start using it pre-op to get used to that quantity.  It's an expensive container that I found on Amazon that keeps the contents cold for days (if ice is added)....but since it doesn't have a handle, I'll probably just pour the cold water into a Tervis tumbler.  Seems silly, but at least I will be able to tell how much I have left to drink and not have to guess on how many ounces I really got in.

So that is all!  My next appointment is on Friday for an upper GI and chest ultrasound at Baptist on University and Nine Mile.  Then comes the very scary psych appointment a week from tomorrow.  Will report on those next! 

Nutritionist Consult #3

I weighed in at 245 -- gained 2 lbs since last visit.  Ugh.

I am not as worried about the gain(s) as I was before now that Nurse Jennifer said that she's never seen an insurance denial because someone had gained weight.  Plus she asked me if Dr. G told me I had to lose weight before surgery (he did not) because sometimes he asks patients to lose a percentage, or in one ladies' specific case, 50 lbs. before surgery.

Ashton and I went over how I did with last month's goals.  I admitted (again) that I hadn't walked any.  However, I was more aware of my fried food intake and gave up soda completely.  Which I am proud of!

This month's goals:  Walk 3 times a week for 20 minutes, do not drink with dinner, keep a food journal, and I forget the 4th.

She gave me an Unjury brand sample of vanilla protein shake and I made it for breakfast Tuesday morning.  It tasted ok but I needed to have blended it a lot better -- didn't like the chunks of powder even though I shook the shit out my Tervis.

Oh I just remembered my 4th goal: to only have high calorie sweets ONCE a week.  I already screwed that one up and it's only Wednesday.

Tomorrow I go see a psychic I've been wanting to see.  We have a one hour one on one session and I am looking forward to hearing what she has to tell me.

Before I left the bariatric office, Hope made my last three NUT appointments and then she also made my one hour appointment with Ashton (the NUT) where she will do a "writeup" for the insurance company submission for surgery approval. 

Hope said that as long as I get everything checked off the list and insurance comes back in about a week, I should be scheduled for surgery as early as late May to early June.  Just in time for my 37th birthday.

I am too excited!

Can't Believe I'm Halfway Done

Tomorrow will be my 3rd of 6 nutritionist appointments!  My last one will be in early May.  I am hoping that come my 4th appointment they will "pencil in" my surgery date so I can start the countdown!

If I have my surgery in earlyish June, I hope to be 60 pounds down by the end of the year...or approx. 180 lbs.  That's probably a size 12, right?  I mean....at 205 I was squeezing into a size of 12 jeans I have in my closet.  Surely an additional 25 lbs. would get me in them comfortably.  Oh, to dream...

Speaking of clothing, I found a brand new sized 14 business suit in my closet today that still has the tags on it.  My mom got it for me one Christmas years ago because I was losing weight and that was my next size down.  I never have gotten into it.  Maybe this fall I will. 

Went to Kohl's yesterday to look for something to wear to a wedding but found absolutely no dresses that would cover my legs.  So I ended up getting a size large cardigan to wear over a dress I already own.  Should've gotten an extra large because I had to push my arms in it and stretch it out. 

I did see a few cute things at Kohl's that I was tempted to buy to put in my "future closet" but I am refraining for now.  Mainly because I really don't know what size I'll be when I get to my goal weight.  And I don't want to spend the money.

Rich and I are planning to book our trip to Ireland soon.  We're going at the end of September to celebrate our 15th wedding anniversary.  If my surgery is in June, by the end of September I'll be about 3 months post-op, so I should be eating regular foods, just not much of anything.  Dublin sight seeing is going to require LOTS of walking, so I am looking forward to having built in exercise during my vacation!  Rich keeps bringing up food and how I won't be eating much but I don't think it is a big deal.  I may be able to have a taste of things here and there but I won't be able to have a pint of Guinness (or any alcohol for that matter).  Food doesn't make a vacation, right?