Time To Get Down & Dirty

Bad news first - I gained another pound and was up to 238.  But, the good news is that I've already lost it.  Hopefully that's a good sign that this stall is breaking.  I've been getting in more protein than I was and I'm also increasing my fluids.  I am so ready to start losing again! 

I think it's time to get down and dirty and really step it up a notch.  I just finished my morning workout.  It was a simple work out, though, I did Just Dance 2 for the Wii.  Later today, I'll go for a walk...er...that's if it warms up.  There was sleet this morning, ick.  I have plans on Friday to renew my Curves membership.  Despite having lost 50 lbs, I'm still not in good shape.  I'm also hoping that having a regular workout routine will not only strengthen my muscles, but that it'll boost my metabolism and create such a calorie deficit that I'll be losing even faster.  Of course, right now any loss is faster, but you know what I mean. 

We went shopping over the weekend and I came across the workout outfit in the picture above.  I got it at Fashion Bug, top and pants for just $10 all together!  I was so happy with that find.  And, it matches the new shoes I bought not long ago at Payless.  You can click the picture of the shoes to the right to get your own pair, they are on sale for just $30.  They are very comfortable and great for walking!  I haven't tried running in them, but I had a dream that I did and they performed beautifully.  I never thought I'd say this, but I can't wait to be able to run again.  In my dream, it was so much fun.  Speaking of dreaming, I've been dreaming a lot lately.  I think this means that my hypopnea is gone!  I haven't dreamed in so long because my sleep was constantly interrupted due to shallowing breathing.  They took my cpap away a few weeks ago because I couldn't get the hang of using it.  They called me non-compliant.  I really hate that word.  Anyone knows me knows that I'm one of the most by the rules people there is, I just couldn't get the hang of that stupid machine.  I'm happy it's gone! 

I've been doing a 31 day photo challenge on Facebook.  Yesterday's was to post a picture of a bad habit you wish you didn't have.  I posted a picture of me weighing myself.  It really is a bad habit.  I do it every day and I know I should only do it once a week.  I told my husband to hide the scale, but he never did.  So, I just keep weighing.  But, the fact that I lost a pound this morning gave me hope.  Maybe tomorrow will be a better day! 

I apologize for my yucky looking legs and feet.  They are splotchy because I have scabies scars.  I'm hoping they fade, but so far they haven't.  I also desperately need a pedicure!  But, you at least get a view of my precious little angel's footprints.  Those, my friends, are actually size.  She was so tiny, weighing in at only 1lb 3oz.  I had her footprints tattooed on my ankle so that wherever I make footprints, hers will be there, too. 

My Surgery Story

Weight loss surgery is like a butterfly coming out of a cocoon.

As I started this post, it reminded me of the birth stories I posted after my children were born.  There were details on their births, the whole experience, people involved.  I realized that's just what this is, it's a re-birth story.  How fitting is it that my room at the hospital had a picture of a butterfly. 

This whole experience was like living my life in a body that wasn't really mine, waiting to go into a cocoon and be reborn into a butterfly. 

I got to the hospital at 6:30 in the morning Monday.  My surgery wasn't scheduled until 8:30 am.  By 7:15, I was prepped and ready to go when my surgeon walked into the room and announced he was ready - an hour early!  I think this was actually a blessing, it left me little time to panic.  I said goodbye to Mike and they whipped me into a holding area.  There, they put me in some compression socks, loaded me up with good drugs and away I went.  I barely remember being wheeled into the OR, in fact, I can't be sure that's what happened because it felt like a dream.  The next thing I remember, I'm being wheeled into PACU, stating very loudly (which is highly unusual for me, I'm soft spoken)  "Oooooooh!  I'm going to throw up!!!"  I said this over and over.  They kept reassuring me that I wouldn't and brought me a wet cloth to place on my forehead.  I don't remember anything else about the recovery room.  I do remember being wheeled to my regular room was painful, every bump we hit, I said, "ooow!"  When we got in there I looked up and said, "Julie!"  then looked over and saw another friend, Sandra.  That's all I remember, I don't remember anything about their visit.  Julie told me they tried to get my dark secrets out of me and I told them I didn't have any.  LOL 

It took forever for my husband to get in to see me.  I don't know what was going on there, I guess there was a mix up in communication, but I was glad when I finally saw him.  I don't remember much about the rest of the day.  Tuesday morning, I was in a lot of pain.  I thought, "OMG, what have I done to myself?"  I was having some very serious regrets, thinking that I would be in so much pain for the rest of my life.  I really wasn't thinking clearly, and I got over those thoughts soon.  It was probably buyer's remorse, this was a major life change. 

They took me for my upper GI with gastrograffin at about 8am.  My nurse told me she should have the results by the time I got back.  I stood in front of a machine while I drank a chalky mixture.  I was afraid I was going to throw up before I even tasted it, but it was fine.  I got to watch it go down my esophagus and into my stomach, it was pretty neat to watch.  They wheeled me upstairs and an hour passed before any results came.  I was getting really nervous that they found a leak, but they didn't.  They just looked at it closer because I had some swelling in my esophagus that caused the drink to go down slowly. 

When my surgeon was operating, he also did a hiatal hernia repair and fixed some scarring on my pancreas (which I only assume was there because I had a life threatening case of pancreatitis about five years ago.)  I think the pain from that is worse than the gastrectomy. 

I know this is an awful picture, but look, I'm smiling!

Once we got the all clear on the leak test, the first thing we did was take out the foley.  I was so happy to have that gone!  The PCA was taken away and I was started on liquid roxicet.  That stuff sat in my stomach like lead!  It is only 5ml but felt like a gallon.  I also started on clear fluids.  Ice chips were first because of the swelling.  Then, water, followed by diluted apple juice.  Tuesday evening I even tried some chicken broth, which sat heavy so I didn't drink much.  I went back to water and decaf tea the next day.  Did I mention that I peed like crazy because I was still on iv fluids?  I walked a bit the first night, probably 4 or 5 total.  I started doing more laps, and was able to do 2 laps at once.  I think the nurse said that each lap was about 180 feet, but I could be wrong.  I did 7 or 8 laps that day.  I also got a shower in and began to feel human again.

Wednesday morning, the sequential compression device came off, though I kept the compression socks on.  I continued to do well with the incentive spirometer.  I only used the CPAP for about an hour the whole time I was there because they decided that it wasn't necessary (not to mention the pressure is way too high.) 

My surgeon came in that morning, saw that I was doing great and released me!  I went home at about 1 pm that afternoon and I was so happy about that.  I stopped at Walgreens on the way home to pick up some nausea patches, which I haven't needed at all.  I haven't had any nausea since I woke up from surgery screaming that I was going to throw up.  The nurses on the station were also very impressed with my progress.  They called me their star patient and said I even passed up Melissa (who was previously the gold standard.)

Yesterday, I was able to get in about 50 oz. of fluid on my own.  I say that's not bad for the first day!  I'll easily make 64 oz. today.  I'm alternating water, peppermint tea, sugar free cherry limeade drink mix and diluted grape juice.  I'm drinking 1 oz every 15 minutes.  When I saw the nutritionist yesterday, she said I could progress to 2 oz every 15 minutes when I'm ready.  But, I'd like to take it slow since I'm getting my fluids in just fine right now.

My husband made chicken alfredo for dinner tonight and it smelled *so* good!  It didn't make me hungry, though, I just wanted to smell it.  It was satisfying.  I haven't tried any jello yet, but I may tomorrow.  I've been able to keep down pill form medications just fine (I'm taking Axid and Propranolol.)  Last night, I skipped a dose of Roxicet and just took liquid tylenol instead and realized that was a mistake.  I really needed the extra pain meds.  Today has been a good day pain wise, but I haven't pushed myself either.  I did manage to make it 7 hours between pain meds so that's a huge plus.

I guess that's it for now.  I'm really doing great and hope I feel much better tomorrow!

Psychological Evaluation

My psychological evaluation was scheduled for December 28th at 2pm.  Although I arrived 15 minutes early to my appointment, I had a sinking feeling that something was wrong.  I got to the window to check in, but they didn't have me on their schedule.  They penciled me in, instead, for December 29th.  By the time I had gotten back to my car, I was  fighting tears back.  I had mentally prepared myself for this and was so disappointed that it didn't happen.  I calmed myself down and reminded myself that it's just one more day. 

The thing is that my appointments keep getting cancelled and rescheduled, and I feel like it's never going to happen, that it's just too good to be true.  Really, after being fat all my life and working toward this surgery for the past 4 1/2 years, could it really happen?  Or, am I just fooling myself, setting myself up for another disappointment.  Is it really too good to be true?  I have a hard time believing that I'll ever be at a normal body weight. 

I went back for my appointment yesterday, cpap in hand.  I was told to bring it because I was seeing the sleep medicine doctor, who also has a background in psychiatry.  I was nervous about taking the cpap because I've been having so many issues with it.  The last few nights have been much better, and I've been able to sleep most of the night with it on - though, I think it's partly because I took some Tylenol PM before bed.  He read the little SD card in the machine and could tell that I've been gradually doing better with it.  My sleep time seems to increase each night.  Overall, he seemed happy with the progress.  He set me up for another appointment in April.  At that time, I'll get to bring home a device that will has a nasal cannula and a pulse-ox to see if my hypopnea has went down.  No more sleep studies for now, thank God!!  He expects me to be able to come off of it eventually.  That was like music to my ears. 

After we discussed the sleep issues, we went on to psychological issues.  He took a basic history - medications, family history, previous psych issues.  The only major issue that came up is that he confirmed about seven years ago, I had a major depressive episode.  It was right after I lost my daughter and I really struggled with daily life.  However, he said that it was understandable given the circumstance and I am fully recovered.  I do have a lot of stress in my life, though.  I have three kids ages 6, 6 and 5.  I am also going back to school to finish my Social Work degree and my husband has been recovering from a traumatic accident last January that left him permanently disabled.  I have decreased my school work load for the spring semester, only taking two classes which are mostly online, because I knew I wouldn't be able to handle the full course load.  He has recommended that I see a therapist once or twice after surgery to discuss any issues that I may have. 

One thing that stood out was him calling me a goody two shoes!  He said he could tell by looking at me that I didn't smoke, drink or do drugs.  He complimented me on the list I made a couple years ago of improvements I wanted to make in my life.  He thought it was a great idea and could see that I've strived to make that list a reality.  He also thought that I was the perfect candidate for this surgery because I am young, have no major health issues, I fully understand the procedure, am aware of the risks and complications and I have the determination to follow through. 

So, that's it!  I have been cleared for bariatric surgery.  And, he didn't commit me.  That's a huge plus. 

Buckling Down

The first few weeks of my liquid protein diet were tough.  I did not do well.  I tried to, but I was just so hungry all the time that I would sneak things here and there.  I saw the nutritionist a couple weeks ago, and since then I have really buckled down and am sticking to the guidelines.  I'm still hungry, but I guess that's just something I'm going to have to deal with.  The first couple weeks, I lost about 14 pounds and then I stalled when I didn't eat so well.  Now that I'm back on track, I have lost 20 lbs.  My clothes are much looser, and I'm able to fit into clothes I haven't wore in awhile.  I think I've went down one pant size, from 28 to 26.  I had some t-shirts that were really tight, but they are now loose.  I'm exactly one month a way from my surgery.  My surgeon didn't give me a set amount to lose, but I was hoping I could lose 30 lbs.  After the stall, I wasn't sure if I'd make it, but it's starting to look more like a reality. 

I went to the CPAP Clinic the other day, and I had really been dreading it.  It turns out, there was no reason at all to dread it.  I didn't get a slap on the wrist for noncompliance like I thought I would.  I wasn't noncompliant by choice, I simply could not tolerate the high pressure they had set for me.  She tried several different pressures and end up decreasing it from 24/20 to 16/12.  It is so much better.  I felt very validated with my concerns, she saw that there were leaks no matter the fit of the mask, the pressure coming out was just way too much.  So, last night I tried it.  It took me about an hour to fall asleep, but I finally did and slept for two hours.  I woke up and the mask was just so incredibly uncomfortable, I had to take it off.  I asked her yesterday about a nasal mask, but she said it was not ideal with my high pressure and I have to stick with a full face mask.  It's going to take a lot of getting used to, I really hate it.  I wish it were more comfortable, then I would have no issue sleeping with it.  As it stands, it's really hard.  I hope it gets better.

Surgery Date!

I got some big news yesterday - my surgery date!  I've been stressing about this a little bit because I was afraid it may interfere with college.  Classes start back up on January 18th.  I'm scheduled for January 10th!  This is perfect timing.

I'll be able to send my twins on the bus to school, not a problem.  But, my daughter is in pre-k and I have to drive her to and from school.  I may have mentioned that my husband had a serious accident last January when he fell from a roof at work, and he's still not totally recovered.  He'll never go back to roofing again, so he has also went back to school, which also starts on January 18th.  So, he'll be able to at least take my daughter to school and hopefully I'll be able to pick her up. 

I also learned yesterday that my insurance does not require pre-approval, which is amazing.  It only requires documentation that the procedure was medically necessary (which is no problem!)  The only hurdle that I have left to get past is the psychological clearance.  Frankly, I am a little nervous about that.  Mostly, because it's the sleep study doctor who will be doing the evaluation and I'm having some major issues with the CPAP.  Hopefully those will be cleared up after I go to the CPAP clinic tomorrow, though.  The evaluation is scheduled for December 28th.  I hope that he will remember that I'm there for psychological clearance and not because I'm having issues with the CPAP.  I was told that I have to take the CPAP with me for the psychological evaluation.  I'm not sure why, it doesn't make sense, but that's why I'm worried about it.

Being a Social Work major, I have some knowledge of psychology and I really don't think he'll find anything to keep me from surgery.  I have no eating disorders, no major depression and no delusional disorders.  I've experienced some depression in the past, but it was after my daughter died, and I think that's pretty normal.  At most, I think he might find a bit of an Avoidant Personality Disorder, but since it really doesn't interfere with life functions, I really think it all boils down to my being shy and feeling awkward around everyone else - which most certainly can be weight related.  I'm embarrassed by my weight and don't like to draw attention to myself.  I do not think that losing weight will change my entire life.  I do think that it will make me healthier and will boost my self confidence.  I will go into the evaluation with an open mind and be totally honest.  I'm just worried that issues with the CPAP will keep me from surgery.  There is actually a lot of anxiety about that.

CPAP Issues

I got my CPAP a couple days ago and I'm having some major issues.
To backtrack, I do not have obstructive sleep apnea, I only had 3 OSA's during my sleep study and they diagnosed me with hypopnea, I had 188 of those.  They set my pressure at 24/20.  Someone mentioned that I probably have a BiPap, but I really don't know.  The lady who set it up said it was a CPAP (and that's what the paperwork says) but the user manual says Respironics BiPAP Auto Bi-Flex.  It has a ramp, and I was able to turn it down from a start of 11 to 4 and that helped enormously to get used to it.  The mask they gave me is a ResMed Mirage Quattro Full Face Mask.

The problems are:

1.  I'm a belly sleeper, and well, there's really no way around that.  To use this thing, I have to give it up.  I really can't afford one of those special pillows right now, my husband has been off work since January when he fell off a roof at work. 

2.  It's extremely uncomfortable.  I hate having it on my face, I even have an issue with my glasses, I just can't stand things touching my face.

3.  It's way too tight, but if I losen it there's leaks.  It leaves red marks all over my face and the tension on the back of my head is painful.

4.  I feel like I'm having a very difficult time fully exhaling, it feels like my lungs just can't hold any more and I can't force what's in there out.

5.  I only wore it for an hour, but my throat is so dry it hurts!   I have tried the humidifier at 3, 4 and 5 and nothing makes a difference.

6.  Once the pressure reaches 18, the mask starts lifting up.

7.  Once the pressure is 18-20, leaks start.

8.  Anything over 20 is full on leaks which I just can't control, the mask is already too tight and the pressure lifts the mask up and causes leaks.  No adjusting stops it.  So I hit the ramp button and start all over, then give up.

9.  Oh, another major thing I've noticed is that over 20, I actually stop breathing and that really freaks me out.  I'm scared to leave it on all night.

I am supposed to take the machine to the cpap clinic next week, so I just need to get through this until then.  I have a perpetual case of allergies and wonder if this is affecting treatment.  I also think I may have a sinus infection (green mucus, bloody nose, I know, eww - sorry.)

Is it normal for the mask to start lifting off the face?  I don't know how I can adjust it anymore, it's just too tight already.  When I go to the cpap clinic, I'll ask about different masks.  I'd really prefer a nasal one, the pillows that I've heard about.