Life without the tunnel vision Monday, August 27, 2007

Last week, my husband turned 31. Well, first he had a kidney stone, and then he turned 31. And since we did very little to celebrate when he turned 30 last year, it was decided that this year would be the year of Big Celebrations. Big as in my mother-in-law came down and we had a big ass barbecue at my mom's house and did various other socializing type things.

Thursday night we celebrated his birthday with a nice dinner out at Jake's, a restaurant we never go to often enough. My mother-in-law and her boyfriend were with us; it was the first time they'd been around me since the surgery and I knew they'd be watching to see how I ate. At one point, Boyfriend asked could I have a roll if I wanted it, and I said yes, I could, but was able to honestly say no, I didn't want one. I was looking forward to a few bites of their amazing crab cake, and even more than that, I was looking forward to some perfectly cooked macadamia panko crusted salmon (I never get salmon at home because Kevin hates it). I didn't want to fill myself up on one roll.

So that's what I had...a little bit of crab cake, a few ounces of salmon, and a lovely to go container that meant I would get to have more yummy salmon the next day for lunch. The three of them each ordered dessert and I joked about Kevin being my surrogate eater, but in reality, all of it sounded too rich, too sweet, too much. I was perfectly content to sit and just talk with them while they finished their desserts and I sipped my water. It was a perfectly lovely meal, and afterwards I walked 3 blocks to the car in heels I'd been wearing all day, and I wasn't a bit miserable. My feet didn't hurt, my knees didn't hurt, and the only thing I was worried about was falling down because it was dark and there were no streetlights.

People talk about their "wow moments", but that was more of a "wow evening" for me. In January, I weighed 318 pounds, and would have eaten three times as much at the restaurant. I would have walked away stuffed and whiny about having to walk three blocks, because my feet would have been killing me. Last week, I weighed 275 (which is still a lot but damn, that's 43 pounds less) and nothing hurt and I wasn't stuffed and I was able to walk 3 blocks without blinking. And finally, FINALLY, a meal out with family was not just about the food we were eating. It was about sitting and spending time talking to people we see too rarely; the food was just a nice accompaniment.

And on Saturday, I was able to do it again. We'd planned carefully, picked out a marinade with very little sugar for my chicken breasts (this one, in case you are looking for a good one), made sure there was some fruit there that I could eat with it. And then I went on and enjoyed the party. I ate my half a chicken breast and cantoloupe, I drank a zillion bottles of water, I cut and served the black forest cake I had made...and I never once felt deprived or left out or weird. And I had a really, really good time with our friends and family.

So you know, even though I really wish someone had told me "Oh, you'll totally throw up every so often for awhile" rather than saying it was a "possible side effect", I am still so glad that I did this. I'm glad because I finally know what it feels like to not be obsessed with my food, to not have to eat it all out of a desperate fear that I will never eat that particular dish again, to be able to just sit and socialize with people and have them be my focus without wondering if they would think badly of me for having seconds.

It's not a whole new life or anything; it's just a better version of the one I already had.

Haves and have nots, part the zillionth Wednesday, August 22, 2007

Remember how I was all braggy about how I have no food intolerances? Yeah, well...my heart was broken by some carnitas the other night. I'm thinking roast pork is something I will have to stay away from because after eating some I ended up spending the 15 minute drive home from the Zoo alternating between hanging my head out the window for fresh air and having my husband pull over so I could heave on the side of the road. But hey, at least I finally know what the hell "foamies" are!

Onward.

I've been looking back over the checking account statements and noticing how much money I've been spending on supplements and vitamins and wow. It really adds up after awhile. I'm lucky enough to live in a world where I have an FSA that can help cover the vitamin costs, but the protein mixes are just going to have to be added to the food budget, I guess. And of course I really only like the Nectar protein mixes, which are $30 for the big container. I couldn't possibly have gotten hooked on the generic vanilla protein shake instead. Add that to the $125 I'll be spending every quarter on vitamins for the rest of my life, and I begin to realize why there is such a large number of post-ops who end up not having optimal success with this surgery.

It's a basic fact that it's easier and cheaper to eat crappy food; take a look at the diet of any broke college student and you'll see what I'm talking about. But you cannot afford to eat crappy food if you are a WLS patient and you want to be both successful and healthy; you have to suck it up and pay for the good cuts of meat, for the high protein/low carb foods, for the stacks and stacks of vitamins. Medicare and Medicaid pay for this surgery now, and here's the thing: to qualify for either of those medical plans, you have to be living below the (ridiculously low) poverty line. And that means that those patients are not leaving the hospital and going home to a situation where they will be able to afford high quality, fresh foods on a regular basis. They will be more likely to have to choose between vitamins for the month and paying the rent, and guess what's going to win? And what kind of aftercare are these patients being given? Something tells me not as much or as good of care as privately insured patients are getting, if my mother's stories about Medi-Cal are any indication (she's the Medi-Cal coordinator for a hosptial here in town so she knows of which she speaks).

I've always been irritated over the fact that having access to good healthcare, healthy food and even active lifestyles is pretty much only available to the middle and upper classes. Yeah, yeah, you can buy cheap fruits and veggies at farmer's markets...but there are no farmer's markets in the ghetto. And yeah, you can go walking or jogging and not need a gym to exercise...but you do need a decent pair of shoes, and some free time not taken up by your totally necessary second job.

And now I'm getting irritated because it seems like even WLS is something that will work better for the middle and upper classes simply because they have more money to afford the vitamins and protein and healthy food that are absolutely essential to being successful afterwards. It makes me want to rail against the unfairness of it all, but I feel like I'm simply shaking my fist in a hurricane.

Who knew I would eventually feel like one of the lucky ones when I was swallowing my 14th vitamin of the day? I certainly didn't.

TMI is probably stating it lightly, but I'm all about honesty Wednesday, August 15, 2007

Last night I was absentmindedly playing with my wedding ring (which has been noticeably looser over the past few days) and I decided that I should weigh myself. When I told Kevin he needed to go get the scale out from his Super Secret Hiding Spot, he arched an eyebrow at me in his patented "Are you really sure about this because I am TOTALLY going to do it" way. I insisted that he go get it because I was certain it would be good news when I hopped on it this time.

And so he did, and so I did, and....

5.3 down from last Thursday. Like magic! Except really it was all that anabolic state scientific stuff and not magic at all. And now I can say I've lost just over 20 pounds since the surgery last month and be Very Impressive. (And also stop being mopey.)

So there was that, which was really super awesome. But there are other things that are not really super awesome. Yesterday I did not go to the gym because I didn't get home until 8pm and it had been a definitely Not Awesome day on the body side.

(And now I am going to regale you with stories about my bodily functions so feel free to not read it if you are eating lunch or something. Or if you just don't like the word poop.)

Back in 2001, I worked at an academic research institution, which is as well known for its striking architecture (designed by Louis Kahn) as for its research (Frances Crick was a scientist in residence while I was there; he had very bushy eyebrows). And part of that striking architecture were breezeways that wrapped around the building, so that to get to the bathrooms, we had to go out on the walkway first. (Stay with me, I swear there's a point to this.) At the time I was working there, I was trying to be more healthy and started taking a daily multi-vitamin every morning, usually right after I ate breakfast at my desk because they had a tendency to make me nauseous. Well, one morning, I took my pill a little too long after I ate my oatmeal and soon I found myself running out the door and onto the breezeway trying desperately not to throw up.

I failed, miserably. Oatmeal barf was all over the breezeway and me, and it was most definitely not fun. And I realized that really, standard multi-vitamins were not for me, because I did not want to puke because of them. So I stuck to children's chewables, until the surgery.

And now I take 14 vitamin pills a day, split up over the hours between 8am and 10pm. (I told you my doctor is very proactive in deficiency treatment!) My morning pills are one B-1, 3 chewable iron, and one chewable multi-vitamin. I usually do them about 20-30 minutes after I eat breakfast, when there's still a little food in my stomach. But yesterday was busy, and I didn't take them for over an hour after breakfast, AND I took them too fast.

And then I spent 20 minutes in the bathroom throwing up, because vitamins still make me nauseous. Who knew?

I don't throw up often (this was only the third time, and this was the first time it wasn't because I ate too fast), but it does happen more easily. Something I don't exactly enjoy, that's for sure, and definitely a downside. At least it's a tolerable downside since A) it does not happen very often and B) even when it does, it's usually over super fast and relatively pain free for me.

Oh, and today? I did my chewables at the very end of my meal, with no waiting. And no nausea, go figure.

On top of the vitamin nausea yesterday, I've had the ongoing saga that is constipation (a saga I'm sure we've ALL been through). Lots & lots of protein + not much fiber = Unhappy Butt. Seriously, it was like my butt just forgot how to work all of a sudden! Before the surgery, I was one of those people who was a once a day, every day girl, so this whole "have to do an ab workout on the toilet" thing was making me not happy. My butt and I quickly became adversaries, warring it out every day as it teased me with a "gotta poop!" signal only to refuse to let go of the goods.

Thanks to the addition of Benefiber to my morning and evening protein drinks (not to mention a more varied diet these days), my butt and I have come to a grudging accord. In fact, I think there may even be a pattern of regularity starting to happen. This makes me happier than you can imagine. It makes me so happy, in fact, that yesterday after a low-key but successful trip to the bathroom, I literally patted myself on the ass and said "Good job, butt!"

I am having conversations with my butt, people. If that doesn't tell you how serious this issue had gotten, I don't know what will.

To sum up: 5 more pounds gone, vitamins make me ill, and my pooper is finally starting to work right. Could life be any better?

Nobody tells you it really sucks sometimes Thursday, August 09, 2007

You know what no one tells you about weight loss surgery before you have it?

No one tells you that it is a complete and total mindfuck.

Oh sure, you read the stories about stalls and hibernation syndrome and slow loss, about people not being able to recognize that they are not as big as they used to be, about patients still wondering if they will fit into a restaurant booth and being shocked when they do.

But those stories are all easy to ignore, because it's much easier to think that you are not going to have any of those issues. You're not going to freak out and melt down when the scale refuses to budge because it's just a number! At least, that's what I believed about myself, because it's much easier to focus on the promise of crazy rapid weight loss and stories about people losing 30 pounds the first month.

I believed it until today, when I found myself sitting in my surgeon's office fighting back tears while telling the dietician that I was not doing so well because when I weighed in this morning I weighed exactly what I weighed 3 weeks ago. Even my home scale backed that up....when I did my one month weigh in at home, it was exactly right where it was 10 days ago. And when I say exactly, I mean it didn't move up or down even 1/10th of a pound. In other words, I've lost 15 pounds in one month, and that all fell off in the first 9 days. (At least I didn't gain 6 pounds, like I dreamed I did last night!)

Surprisingly, (and also awesomely) Laura the dietician said she wasn't concerned in the least, that 15 pounds in one month is pretty average, that plenty of patients stall like this in the beginning. She was, in fact, pretty damn happy with what I've been eating and how much water I've been drinking and how much I've been working out. But it didn't make me stop wanting to cry.

Dr. Mueller did better at making the "I want to cry" feeling go away, because he is also awesome. He told me that in fact, the stall tells him that I'm doing everything right. Totally counterintuitive, right? Well, we talked about the fact that I am down a size in clothes and that when I measured myself this morning (I'm doing monthly measuring) I'd lost 14.5 inches (I KNOW! Can you believe that?). And when he heard that part he said "See, now I really know you're doing what you're supposed to!" and went on to explain that the lack of weight loss combined with the shrinking size means that I'm already shifting from a catabolic state to an anabolic state. And being in an anabolic state is good! And the weight should start coming off again soon, he said, and when it does it'll be all fat.

Of course, the whole anabolic vs catabolic state confused me so I looked it up as soon as I got to work and here's the best explanation I found:

One way of categorizing metabolic processes, whether at the cellular, organ or organism level is as anabolic or catabolic. Catabolism is the part of metabolism that breaks down molecules into smaller units to generate energy and simultaneously takes measures to conserve energy. Stress, such as during weight loss program, can put the body into the catabolic state, in which the body can experience muscle loss, reduced metabolic rate with a corresponding reduced calorie expenditure and lower perceived energy levels, and weight gain in the form of fat. One aspect of the catabolic state is that it can be characterized as having high cortisol (a catabolic stress hormone) levels and low testosterone (an anabolic hormone) levels.

Conversely, in the anabolic state the body experiences muscle maintenance or growth, normal metabolic rates, and weight loss in the form of fat. The anabolic state can be characterized by relatively low cortisol levels and high testosterone levels.

So yay me? I guess? It's just so fucking hard to deal with, because I've never attempted to lose weight without that number on the scale being the be all, end all measure of success. And it wasn't just me using that to keep track of how well I'd done, it was my doctors and my Weight Watchers leaders and friends and everyone. It's incredibly hard for me to let go of that, it's incredibly hard to know that whenever someone asks me how much weight I've lost since the surgery I can only say 15 pounds; I'm so ashamed/disappointed that I'll probably add in the 10 pounds I lost on my pre-op diet and say 25 instead. Or maybe I'll just keep saying "I don't know, but I've lost a clothing size!" So far, that seems to make people happy for me.

But I still can't wait until I can answer that question with a number instead.

Cures what ails me Tuesday, August 07, 2007

The past 36 hours have been kind of hard for me. Yesterday I ate some soup at work and managed to not chew a piece of chicken enough, and I discovered last week that the only thing that will make me sick is not chewing enough and eating too fast. Despite this, I managed not to throw up, but when it came time for me to take my afternoon vitamins, those fuckers got stuck in a bad way.

Now see here's the thing. My surgeon is really aggressive in his practice, and that extends to the prevention of vitamin deficiency. What that translates to is 14 pills a day, including 6 calcium pills. And those calcium pills are quickly becoming the bane of my existence. Luckily, I have already found a liquid alternative I will be investing in soon if this doesn't get easier soon.

Anyway, my afternoon pills include 3 of my 6 calcium pills, and taking them so soon after my little "not chewing enough" incident made my pouch super not happy, and also sore enough that this morning, even drinking was hard. I was dreading my vitamin taking today until my friend told me to try using warm water to take them since that's what she has to do to take her vitamins. And it worked! Score one for my friend. So I got the vitamins down, but eating was still a touchy subject all day.

The whole thing left me feeling worn out and cranky and a little pissed off at my body for rebelling this way. I came home and sulked and ate some smushy cottage cheese, and then Kevin and I headed to the gym.

And thank goodness we did.

A half hour on the elliptical and a round of circuit training was exactly what I needed. About 10 minutes into my time on the elliptical, I closed my eyes and concentrated on my legs and my breath and the way I felt like I was running through clouds. And right then, as I built up a good sweat and felt my heart race a little more suddenly became very aware of my ass, I made up with my body. I didn't just make up with it, I fell in love with it all over again.

We've got a complicated relationship, my body and I. It's got a lot of adjusting and relearning to do and sometimes that adjusting is going to hurt and be sucky, but I've just got to remember how totally fucking awesome I felt tonight on the elliptical to make this whole wacky deal all worth it.

Placeholder Monday, August 06, 2007

I never get tagged for memes. Never. It's probably because people who know me would figure I'd just ignore the tagging; I'm a bitch like that sometimes. But Dagny tagged me and I'm in between ruminations so I will go ahead and respond. But I won't tag anyone else because A) I'm lazy and B) everyone's probably already been tagged.

Eight Obscure Things About Me

1) When I was a young, naive, virginal college freshman, I declared that I would only sleep with 10 men over my lifetime. Luckily for me, things worked out with Kevin; if they hadn't I'd have been screwed because he was #10.

2) I spent a large amount of my life believing that I have blue eyes and am 5'7". Turns out my eyes are more on the gray side of blue-gray...and I'm only 5'6".

3) My hair has been literally every semi-natural color it could possibly be; from white blonde to raven black. I've been dying it since I was 18 years old and right now, I honestly have no idea what my natural color is.

4) I was a Girl Scout from the age of 8 to the age of 13; I quit right after receiving my Silver Star, which is the second highest award you can receive in Girl Scouts (kind of like the award right before the Eagle Scout award). I used to have a T-shirt that said "Girl Scout gone bad". I wish I could find another one like it.

5) I learned how to read sometime between the ages of 3 and 4, but I didn't learn to tie my shoes until I was almost 7. My brain has always worked better than my fingers.

6) I graduated 18th in a class of 350 when I graduated from high school. I am S-M-R-T smart.

7) Sign that Kevin and I were truly meant to be together: My mom got pregnant despite an IUD; his got pregnant despite being on the Pill. If I ever get pregnant (Kevin's had a vasectomy), I figure our baby will be some kind of oracle sent by the Universe.

8) From my father, I inherited a second toe that's longer than my first. From my mother, I inherited a right hand pinky finger that is shorter than my left hand pinky finger.

The space between Wednesday, August 01, 2007

You know what's weird?

What's weird is that in all of my research that I did before I finally decided on the RNY, I never managed to realize that the topic of weight loss surgery is basically a battlefield.

On the one side are the people who truly believe with every bit of their being that WLS is bad and evil and unnecessary. They can pull out piles of testimonials from people who had horrible, terrible outcomes; they will tell you repeatedly about the worst complications that can happen, and death is not the worst of them. They will call WLS mutilation and amputation and deformation, because it is the worst thing they can imagine anyone doing to themselves.

On the other side are the people who think that WLS is nothing short of a miracle, the answer to every medical problem ever associated with being obese. They will tell you about the dozens of people they know who had the surgery and are doing GREAT and are happy and healthy. They will point out that complications are part of any surgery, that overall statistics are highly favorable.

That first group would be quick to tell me that I have doomed myself by having the RNY done. I would be regaled with stories about vitamin deficiencies and intestinal blockages and staple leaks that will surely make my life miserable over the next few years. My own stories about friends who are 2, 5, even 10 years out and in fantastic health will fall on deaf ears, or will be called anomalies.

The second group would be sure to heap praise on me, and ask me when I was going to convince my mother that she needed to do it to because it will make her life so much better! She should do it right now! They would be sure to preach to me about how horrible fat is, how it ruins your health and your life and everything is better forever once you have the surgery.

I somehow managed to never notice that these two sides are as bitter and angry towards each other as red states and blue states. And now, I find myself firmly in the Green Zone between them. I just wish that both of the groups would wake the hell up and realize that they're both totally wrong and both totally right. If there's one thing I learned when I was trying to decide about the surgery, it's that there is no right answer for everyone. For some people, it truly is a life-saving procedure because they are suffering from so many problems related to their weight that they are dying and this gives them their life back. For others, it turns into a nightmare of complications that leaves them more miserable than before. That's just the facts, ma'am.

I am not someone who believes that every fat person is unhealthy, because I've been an active, athletic and healthy fat girl for my entire life. Hell, I've been healthier than most of my thinner friends. But I cannot deny that being morbidly obese can and does cause health problems, because I have watched my mother suffer for years from ailments directly related to her weight. I have seen the pain, watched the pill taking, heard the wheezing when she gets worn out. She is a wonderful person, and she is the reason for the self confidence I've always had, but even she would not be able to deny that her weight has affected her quality of life. And I saw myself heading down that same path, and I had to find a way to stop it, and WLS was how I did it.

That said...I have to admit that as happy as I am with my WLS outcome, there are times when I wish that I had been able to do what my coworker/friend has been able to do. Sometimes I wish that I had been able to buckle down and work out and eat according to a strict diet and lose the weight as well as she has been. For her, that worked, and the idea of having surgery to help her is foreign. And yet, we are both able to support each other and cheer each other on, because we're both in the Green Zone. We're not taking sides, we're not preaching, we're just...existing, and doing what we've decided we need to do for ourselves.

If only everyone was, because the last thing we all need during this whole weight loss journey thing is a bunch of arguments over the "right way" to do it. It's time for people to shut their mouths and stop telling other people what they should do, you know? That energy could be better spent taking care of yourself instead.

Just something to think about.