A few days ago, I had my 10-week surgiversary. I'm off 3 of my medications, down 47 pounds from my highest and down 30 pounds since surgery. I'm down two pants sizes. I've gone to yoga class twice and am in my second week of cardio workouts at the gym (30 minutes three times a week to start).
This week, work has been stressful. Tuesday afternoon I stopped at the gym on my way home, and walking on the treadmill felt GOOD. And this afternoon, my neighbor and I went for a walk; we did the longer loop (1.25 miles), briskly, and I felt GREAT. I don't think I've ever felt good or great exercising. If I exercised, I endured it. Suddenly I'm enjoying it, something I haven't done since I was a teenager. Monday I have an evaluation with a personal trainer, and I'm so excited.
Brainstorming
There's another real positive this week. A few times, my therapist and I have talked about what I'll do when I want to eat for comfort. What comforts me? I asked myself, and the answer was easy: snuggling with my husband. Great! Snuggling with Paul is a great way to cope.
The funny thing is, when I needed comfort, Paul was at work. So no snuggling. So I reverted, kind of. I stopped at CVS and bought a snack-size bag of kettle-cooked chips. I went home, took care of the dogs and then crawled in bed with my chips and a book.
They tasted okay. They didn't taste great or disgusting. I enjoyed the crunch. I enjoyed the salt. I didn't enjoy the oil.
My therapist has been encouraging me to notice without judging, and that's what I did. I noticed my decision, my reaction, my experience. I haven't told myself I was "bad" or I "cheated." I made a less-healthy choice. I don't think I'll be running to make another.
How is that a positive? Well, there are a few positives there: I chose a small bag of chips rather than a massive one, and I didn't judge myself. But the best part came in this week's therapy session; my therapist and I brainstormed and came up with a great list of things I can do for comfort or distraction:
call Paul
read a book
take a walk
go out with my camera
take a shower
sit in the gazebo
call a friend
play with my crystals
cross stitch
color
practice yoga
meditate
watch something funny
snuggle with one of the dogs
do a doggie play date with the neighbor
listen to music
clean
write ("name it to tame it")
spend 15 minutes tackling a large project (copying music from CDs to my Mac or sorting old photos).
This morning I met with my neurologist, Dr. K, who I see for migraines. I hadn't seen her since before surgery (although I'd spoken with her — she'd called me in the hospital room after surgery to check on me). She was thrilled with my progress — since surgery, I haven't had a headache that required Tylenol. I was worried to tell her I haven't been taking my preventative medication (too disgusting to crush, too large to swallow), but she was happy I don't need it. After checking on my experience with the hospital, she repeatedly said how wonderful I look and how well I'm doing. She told me she's proud of me and gave me a hug when I left. She's the best doctor.
When I first saw Dr. K, she referred me to an ear/nose/throat doctor to make sure my sinuses (one cause of headache for me) were okay. And she referred me to Dr. H., a neuro-endocrinologist, of which I'd never heard. When I met with Dr. H, he said you have different doctors who function in their own area; he's the guy in the middle, figuring out how things are connected. (Isn't that cool? Where has this man been my whole adult life?) Dr. H ordered a bunch of tests. I finally thought someone would figure out how my weight gain, depression, hormones and migraines were connected.
The tests all turned out normal. I was crushed.
But Dr. H, instead of sending me away, proceeded to treat my symptoms. Ultimately, to give me a break from the roller coaster of hormones, depression and migraines, he put me on a medication that shut down my hormonal cycle. Then he added back in estrogen and progesterone, in right doses.
Around the same time, I saw a new nurse practitioner at my psychiatrist's office. I wasn't doing well, and he added Abilify. It made such a difference to my depression, possibly because I'd been on the combination of Wellbutrin and Zoloft for many years. The Abilify really kicks my system into a higher state of working.
So there I was: depression well under control, hormones level and well under control. It was the best I'd felt in my life. And because I wasn't battling those obstacles, I was able to really attack my weight problem.
In a way, Dr. K is a big part of why I'm here today. She referred me to Dr. H who got my hormones under control and removed half my obstacles. And she referred me to my PCP, who referred me to the BIDMC bariatric program. To have Dr. K be happy for me, proud of me, thrilled for me, was awesome.
A few non-scale victories (NSVs) to share. (I'm thinking of doing this regularly... a good reminder to claim my successes, large and small.)
Thursday afternoon I went to Target. I used to get a personal Pizza Hut pizza on my way out. I thought about it. I skipped it.
My neighbor and I were supposed to go to the gym Thursday afternoon, but she couldn't go. It was my first workout, and I really didn't want to walk in alone. I went anyway and with a goal of 20 minutes on the treadmill, I did 30.
Friday afternoon I was planning on going back to the gym. My sister-in-law called and asked if I could do emergency babysitting for my 6-year-old niece. I picked her up and we went for a walk with the dogs to make up for treadmill time.
Yesterday marked 8 weeks post-op, and I celebrated by bagging up clothes that are too big.
I've already mentioned I'm down one size, and two days this week,
people mentioned my clothes look too big. I tried on a shirt I bought
at Christmas that was too small then; it fits beautifully now. Today I dropped off the too-big clothes at a donation center.
Recent non-scale victories: Several days I've eaten all my protein in food and not needed a protein shake. I've joined the gym and am starting tomorrow. I signed up for a yoga class and start Monday. And I'm doing really well off one of my anti-depressants.
For scale victories, I'm down 44 pounds since last July, 28 pounds since surgery. Interestingly, my weight loss actually picked up this week, as I increased my calories. (I hadn't been meeting my minimum recommendation.)
This morning, I headed into Boston for a nutrition class. I was graduated to stage 5, my final and permanent post-op diet stage — not a diet, but a new way of eating, my dietician pointed out.
I
don't have protein or calorie goals right now. For the next four months,
I'm to focus on getting three balanced meals a day, and my dietician
said calorie totals can vary quite a lot within that.
My ultimate goal for a meal is 2-4 oz. of (usually lean) protein, 1/2 cup veggies/fruit and 1/4 cup starch, and I still need to eat some healthy fats.
I'm
looking forward to snacking on almonds, maybe with some cut-up
strawberries. And adding half a peeled apple (apple skin could be hard
to digest) to my string cheese snack.
But I'm intimidated by the fact that no food is forbidden me. (Certain foods are discouraged — ice cream, calorie-laden drinks, chips, pretzels, etc. — because the focus is on nutrition.) For the past 10 weeks, I've relied on my food guidelines, making choices within their safe boundaries. Suddenly, my choices have exploded, and now I need to rely only on myself — on my knowledge, on my recent good habits, on my strength. That's a scary thought.
I reframe it in my head, finding the positive. "There's so much room for creativity," I tell myself, and imagine having fun packing my bento lunchbox. It has four compartments, so I could do Greek yogurt with berries and granola, apples slices with peanut butter and half a Wasa cracker, leftover chicken with veggies and rice, string cheese and grape tomatoes. Doesn't that all sound delicious? And nutritious. And there you go. That's my goal: to make food decisions based on nutrition and taste.
Speaking of which, I started back on caffeinated coffee. Where's the nutritional value, you ask? Good question. Clearly there always will be exceptions. I'm okay with coffee being one of them. (And if you've seen the photo of me with my first sips of real coffee, you'd know I'm very okay with it.)
You might know, looking at my face today, that something is wrong — but you'd have no idea what. And it's something that most of you (thankfully) can't imagine.
There are lots of ugly truths about being morbidly obese.
There are the worries (What if I don't fit in the booth?) and the certainties (I'll need to ask for a seatbelt extender on the plane), both closely connected, for me, with shame.
Part of my goal with this blog is to be done with shame. So here goes sharing the most shameful part, for me, of being morbidly obese: I get a rash where my tummy folds over itself.
Friday I joined a gym, and yesterday I was going to do my first workout on the way home from work. But during the day I noticed my tummy hurt, and when I looked in the mirror, I was shocked. Raw, red, angry. Painful.
No workout, I decided. Instead, I called the doctor.
In the past, this has been a yeast rash. This time (even more shameful) it also looks fungal (such a dirty word).
My doctor has a three-pronged approach: steroid ointment to address the immediate pain, diflucan to address the yeast, and next week, when it's cleared up, a preventative cream. Thank goodness I went to the doctor. This is the worst it's ever been, and I'm, at best, constantly uncomfortable.
As I lose weight, of course, the rash might improve — unless I'm left with empty hanging skin (a real possibility with weight-loss surgery). Sometimes insurance companies consider repeated rashes a medically necessary reason for plastic surgery to remove excess skin. I'm hoping my skin will magically shrink as the rest of my body does — but I'm beginning to prepare, in my head, for the possibility of plastic surgery.
And that, my friends, is something I never thought I'd say.
